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General NPI Number Information
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NPI Number | 1699240507
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Entity Type | Organization
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Legal Business Name | COMPLETE TUTORING & MENTORING LLC
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Dates
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Enumeration Date | 10/06/2018
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Last Update Date | 11/11/2019
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Provider Practice Location Address
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Address Line | 8555 CEDAR PLACE DR STE 112
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-2344
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Country | US
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Telephone | 317-750-5189
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Fax |
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Provider Business Mailing Address
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Address Line | 9135 N MERIDIAN ST STE B8
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-1816
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Country | US
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Telephone | 317-750-5189
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHENAY GOLDEN
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Credential |
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Telephone | 317-750-5189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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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 | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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