Healthcare Provider Details

I. General information

NPI: 1508594094
Provider Name (Legal Business Name): VIAQUEST COMMUNITY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 08/11/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7830 JOHNSON RD
INDIANAPOLIS IN
46250-2075
US

IV. Provider business mailing address

525 METRO PL N STE 300
DUBLIN OH
43017-5320
US

V. Phone/Fax

Practice location:
  • Phone: 317-396-0683
  • Fax:
Mailing address:
  • Phone: 614-339-0814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: NANCY HOUSMAN
Title or Position: DIRECTOR OF BILLIN
Credential:
Phone: 614-339-0814