Healthcare Provider Details
I. General information
NPI: 1275499055
Provider Name (Legal Business Name): EVERRISE RECOVERY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/24/2025
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3266 N MERIDIAN ST FL 9
INDIANAPOLIS IN
46208-5846
US
IV. Provider business mailing address
3266 N MERIDIAN ST FL 9
INDIANAPOLIS IN
46208-5846
US
V. Phone/Fax
- Phone: 317-289-5253
- Fax:
- Phone: 317-289-5253
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KENDRICK
E
MAJOR
Title or Position: CLINICAL DIRECTOR/PROGRAM MANAGER
Credential: LCSW
Phone: 317-289-5253