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General NPI Number Information
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NPI Number | 1205046869
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Entity Type | Organization
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Legal Business Name | GOODWILL EDUCATION INITIATIVES INCORPORATED
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 1635 WEST MICHIGAN STREET
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-4388
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Country | US
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Telephone | 317-524-4638
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Fax | 317-524-4002
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Provider Business Mailing Address
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Address Line | 1635 WEST MICHIGAN STREET
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-4388
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Country | US
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Telephone | 317-524-4638
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Fax | 317-524-4001
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Authorized Official
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Title or Position | SPECIAL EDUCATION DIRECTOR
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Name | MR. GREGORY D MCCLURE
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Credential | DIRECTOR
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Telephone | 317-524-4043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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