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NPI Code Detail

MEDICARE: CARPE DIEM INDIANA INC

MEDICARE: CARPE DIEM INDIANA INC
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
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1376086603
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARPE DIEM INDIANA INC
Provider Business Mailing Address
First Line : 2240 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-5728
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2240 N MERIDIAN ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-5728
Country : US
Telephone Number : 210-718-4172
Fax Number :
Authorized Official
Title or Position : COO
Name : NICHOLAS FLEEGE
Credential :
Telephone Number : 210-718-4172
Provider Enumeration Date : 11/17/2016
Last Update Date : 11/17/2016

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Directions to “CARPE DIEM INDIANA INC ” Practice Location

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