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General NPI Number Information
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NPI Number | 1831957844
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Entity Type | Organization
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Legal Business Name | PERSIST EDUCATION SERVICES LLC
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Dates
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Enumeration Date | 03/13/2024
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 3039 N POST RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46226-6543
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Country | US
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Telephone | 317-300-6644
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Fax |
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Provider Business Mailing Address
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Address Line | 5765 TEAK LN
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City | MCCORDSVILLE
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State | IN
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Zip | 46055-0107
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Country | US
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Telephone | 317-300-6644
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. CHRISTINA COCKRELL
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Credential |
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Telephone | 317-300-6644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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