Healthcare Provider Details

I. General information

NPI: 1659633758
Provider Name (Legal Business Name): LIVINGHOPE CONSULTING & COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2012
Last Update Date: 06/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 WESTHAVEN DR SUITE F
INDIANAPOLIS IN
46254-2744
US

IV. Provider business mailing address

6350 WESTHAVEN DR SUITE F
INDIANAPOLIS IN
46254-2744
US

V. Phone/Fax

Practice location:
  • Phone: 317-291-9388
  • Fax: 317-291-9389
Mailing address:
  • Phone: 317-291-9388
  • Fax: 317-291-9389

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 Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ADETUNJI SAMUEL ADEYANJU
Title or Position: CEO
Credential:
Phone: 317-937-9676