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General NPI Number Information
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NPI Number | 1720938350
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Entity Type | Organization
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Legal Business Name | KINDRED WELLNESS COMPANY
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 117 E BEVERLY DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46205
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Country | US
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Telephone | 317-662-4244
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Fax |
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Provider Business Mailing Address
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Address Line | 1113 E 86TH ST STE 207
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1811
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Country | US
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Telephone | 317-662-4244
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST/OWNER
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Name | GRACE THEOFANIS
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Credential | LMHC
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Telephone | 317-662-4244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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