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General NPI Number Information
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NPI Number | 1699780429
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Entity Type | Organization
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Legal Business Name | ESTHER'S PLACE
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1810 EAST 62ND ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-2378
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Country | US
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Telephone | 317-466-0657
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Fax | 317-466-0658
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Provider Business Mailing Address
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Address Line | 1810 EAST 62ND ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-2378
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Country | US
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Telephone | 317-466-0657
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Fax | 317-466-0658
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. CLAUDETTE DAILEY
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Credential | MS, MAC, CADCII
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Telephone | 317-466-0657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34004563A
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License Number State | IN
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