Healthcare Provider Details

I. General information

NPI: 1598194516
Provider Name (Legal Business Name): DAMAR SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2013
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6067 DECATUR BLVD
INDIANAPOLIS IN
46241-9606
US

IV. Provider business mailing address

6067 DECATUR BLVD
INDIANAPOLIS IN
46241-9606
US

V. Phone/Fax

Practice location:
  • Phone: 317-856-5201
  • Fax: 317-856-2333
Mailing address:
  • Phone: 317-856-5201
  • Fax: 317-856-2333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number73861
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number73862
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number73863
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number73864
License Number StateIN
# 5
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number73860
License Number StateIN

VIII. Authorized Official

Name: MS. JIM L DALTON
Title or Position: CEO
Credential:
Phone: 317-856-5201