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General NPI Number Information
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NPI Number | 1558819037
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Entity Type | Organization
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Legal Business Name | ECHELON SERVICES CORPORATION
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 4040 W 71ST ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-5722
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Country | US
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Telephone | 317-798-9690
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 W 71ST ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-5722
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA SMITH
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Credential |
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Telephone | 317-798-9690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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