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General NPI Number Information
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NPI Number | 1306978846
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Entity Type | Organization
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Legal Business Name | LIVING CONNECTION, INC.
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Dates
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Enumeration Date | 03/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6839 S LAWNDALE AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46221-4731
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Country | US
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Telephone | 317-374-7795
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Fax | 317-856-0258
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Provider Business Mailing Address
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Address Line | 6839 S LAWNDALE AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46221-4731
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Country | US
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Telephone | 317-374-7795
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Fax | 317-856-0258
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JUDITH ANNE HANCOCK
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Credential | MS, OTR, CIMI, MT
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Telephone | 317-374-7795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31000322A
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License Number State | IN
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