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General NPI Number Information
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NPI Number | 1912299231
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Entity Type | Organization
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Legal Business Name | SAFE JOURNEY LLC
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 8316 SOUTHERN SPRINGS DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-8413
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Country | US
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Telephone | 317-692-9232
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Fax |
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Provider Business Mailing Address
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Address Line | 8316 SOUTHERN SPRINGS DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-8413
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Country | US
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Telephone | 317-692-9232
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Fax |
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Authorized Official
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Title or Position | PROPRIETOR
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Name | MS. AMELIA A HAGEDORN
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Credential |
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Telephone | 317-692-9232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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