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NPI Code Detail

MEDICARE: CSL GREENBRIAR LLC

MEDICARE: CSL GREENBRIAR 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
1320700000XPhysical Disabilities Residential Treatment Facility150117991IN

General Provider Information

NPI Number : 1639569478
Entity Type Code : Organization
Provider Name (Legal Business Name) : CSL GREENBRIAR LLC
Provider Business Mailing Address
First Line : 8800 SPOON DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4230
Country : US
Telephone Number : 317-899-6777
Fax Number :
Provider Business Practice Location Address
First Line : 8800 SPOON DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46219-4230
Country : US
Telephone Number : 317-899-6777
Fax Number :
Authorized Official
Title or Position : VP OF OPERATIONS
Name : DAWN MOUNT
Credential :
Telephone Number : 972-308-8338
Provider Enumeration Date : 02/02/2015
Last Update Date : 06/03/2024

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Directions to “CSL GREENBRIAR LLC ” Practice Location

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