MEDICARE: SARA CRUZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1225843501
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA CRUZ

Provider Business Mailing Address
First Line	:	550 CONGRESSIONAL BLVD.
Second Line	:	SUITE 115
City	:	CARMEL
State	:	IN
Zip	:	46032-5400
Country	:	US
Telephone Number	:	317-249-2242
Fax Number	:	844-289-6798

Provider Business Practice Location Address
First Line	:	2555 YEAGER ROAD
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-2454
Country	:	US
Telephone Number	:	317-249-2242
Fax Number	:	844-289-6798

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2025
Last Update Date	:	02/12/2025

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Directions to “ SARA CRUZ ” Practice Location

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