Healthcare Provider Details

I. General information

NPI: 1629463906
Provider Name (Legal Business Name): CATHOLIC CHARITIES INDIANAPOLIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2015
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 N MERIDIAN ST
INDIANAPOLIS IN
46202-2305
US

IV. Provider business mailing address

1400 N MERIDIAN ST
INDIANAPOLIS IN
46202-2305
US

V. Phone/Fax

Practice location:
  • Phone: 317-236-1500
  • Fax:
Mailing address:
  • Phone: 317-236-1500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID J. BETHURAM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 317-236-1530