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General NPI Number Information
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NPI Number | 1295205615
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Entity Type | Organization
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Legal Business Name | MONUMENTAL BEHAVIORAL HEALTH INC
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 1201 N POST RD STE C
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4246
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Country | US
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Telephone | 317-405-8333
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Fax | 317-672-2398
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Provider Business Mailing Address
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Address Line | 1201 N POST RD STE C
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4246
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Country | US
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Telephone | 317-405-8833
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Fax | 317-672-2398
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT MOCHEK
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Credential |
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Telephone | 317-370-1254
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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