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General NPI Number Information
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NPI Number | 1265928733
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Entity Type | Organization
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Legal Business Name | FROM THIS SPACE, INC.
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Dates
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Enumeration Date | 07/07/2018
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Last Update Date | 07/07/2018
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Provider Practice Location Address
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Address Line | 1234 W 26TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-5307
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Country | US
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Telephone | 317-728-1601
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18044
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City | INDIANAPOLIS
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State | IN
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Zip | 46218-0044
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Country | US
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Telephone | 317-728-1601
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | TIFFANY S. ROBINSON
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Credential |
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Telephone | 317-728-1601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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