Healthcare Provider Details

I. General information

NPI: 1003628496
Provider Name (Legal Business Name): SMARTY PANTS DAYCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5355 N POST RD
INDIANAPOLIS IN
46216-1114
US

IV. Provider business mailing address

2035 N RITTER AVE
INDIANAPOLIS IN
46218-4934
US

V. Phone/Fax

Practice location:
  • Phone: 317-993-2439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TURISTA JACKSON
Title or Position: PRESIDENT
Credential:
Phone: 832-744-0385