Healthcare Provider Details

I. General information

NPI: 1558628362
Provider Name (Legal Business Name): WARNER TRANSITIONAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11075 N PENNSYLVANIA ST
INDIANAPOLIS IN
46280-1091
US

IV. Provider business mailing address

11075 N PENNSYLVANIA ST
INDIANAPOLIS IN
46280-1091
US

V. Phone/Fax

Practice location:
  • Phone: 317-815-0505
  • Fax:
Mailing address:
  • Phone: 317-815-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL B FLORES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 317-815-0505