Healthcare Provider Details

I. General information

NPI: 1528770831
Provider Name (Legal Business Name): RUGGED GRACE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W GREEN MEADOWS DR STE 106
GREENFIELD IN
46140-3205
US

IV. Provider business mailing address

400 W GREEN MEADOWS DR STE 106
GREENFIELD IN
46140-3205
US

V. Phone/Fax

Practice location:
  • Phone: 317-406-8191
  • Fax: 317-406-8191
Mailing address:
  • Phone: 317-406-8191
  • Fax: 317-406-8191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. JENNIFER RENEE MENSER
Title or Position: MANAGING MEMBER
Credential: LCSW
Phone: 317-698-3599