Healthcare Provider Details

I. General information

NPI: 1396924742
Provider Name (Legal Business Name): CORRECTIONAL MANAGEMENT COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 KEYSTONE XING SUITE 1040
INDIANAPOLIS IN
46240-2118
US

IV. Provider business mailing address

9000 KEYSTONE XING SUITE 1040
INDIANAPOLIS IN
46240-2118
US

V. Phone/Fax

Practice location:
  • Phone: 765-456-1089
  • Fax: 765-456-1091
Mailing address:
  • Phone: 765-456-1089
  • Fax: 765-456-1091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01047000
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number01047000
License Number StateIN

VIII. Authorized Official

Name: DR. DAVID POSEY
Title or Position: DOCTOR
Credential: MD
Phone: 765-456-1089