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NPI Code Detail

MEDICARE: LANDMARK RECOVERY OF INDIANAPOLIS LLC

MEDICARE: LANDMARK RECOVERY OF INDIANAPOLIS LLC
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
1324500000XSubstance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1518507011
Entity Type Code : Organization
Provider Name (Legal Business Name) : LANDMARK RECOVERY OF INDIANAPOLIS LLC
Provider Business Mailing Address
First Line : 4835 E CACTUS RD STE 130
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85254-3545
Country : US
Telephone Number : 480-296-8619
Fax Number :
Provider Business Practice Location Address
First Line : 6330 DIGITAL WAY
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46278-1667
Country : US
Telephone Number : 888-448-0302
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF RCM
Name : BROOKE ZIMMERMAN
Credential :
Telephone Number : 480-296-8619
Provider Enumeration Date : 01/13/2020
Last Update Date : 01/13/2020

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Directions to “LANDMARK RECOVERY OF INDIANAPOLIS LLC ” Practice Location

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