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General NPI Number Information
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NPI Number | 1457875460
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Entity Type | Organization
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Legal Business Name | INDIANA DEPARTMENT OF CHILD SERVICES
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 302 W WASHINGTON ST RM E306
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-2738
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Country | US
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Telephone | 317-234-4443
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Fax |
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Provider Business Mailing Address
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Address Line | 302 W WASHINGTON ST RM E306
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City | INDIANAPOLIS
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State | IN
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Zip | 46204-2738
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Country | US
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Telephone | 317-234-4443
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Fax |
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Authorized Official
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Title or Position | AGENCY HEAD/DIRECTOR
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Name | MS. MARY BETH BONAVENTURA
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Credential | JD
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Telephone | 317-234-1391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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