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General NPI Number Information
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NPI Number | 1720486376
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Entity Type | Organization
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Legal Business Name | AUTISM SOCIETY OF INDIANA
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 12/15/2014
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Provider Practice Location Address
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Address Line | 3951 N MERIDIAN ST SUITE 220
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-4057
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Country | US
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Telephone | 800-609-8449
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Fax |
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Provider Business Mailing Address
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Address Line | 3951 N MERIDIAN ST SUITE 220
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-4057
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Country | US
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Telephone | 800-609-8449
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE ALLY
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Name | DANA RENAY
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Credential |
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Telephone | 800-609-8449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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