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General NPI Number Information
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NPI Number | 1780311647
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Entity Type | Organization
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Legal Business Name | FULL CIRCLE FAMILY SERVICES LLC.
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Dates
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Enumeration Date | 08/02/2022
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Last Update Date | 08/02/2022
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Provider Practice Location Address
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Address Line | 11527 CONGRESSIONAL LN
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-9700
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Country | US
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Telephone | 317-965-4017
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Fax |
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Provider Business Mailing Address
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Address Line | 5625 SUNNYSIDE ROAD
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City | INDIANAPOLIS
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State | IN
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Zip | 46235-8513
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Country | US
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Telephone | 317-965-4017
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATASHA ANN GRAHAM
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Credential | M.ED
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Telephone | 317-965-4017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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