MEDICARE: COMMUNITY ADDICTION SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	87001560A	IN
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043439169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY ADDICTION SERVICES INC.

Provider Business Mailing Address
First Line	:	1431 N DELAWARE ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-2416
Country	:	US
Telephone Number	:	317-536-7100
Fax Number	:	317-536-7101

Provider Business Practice Location Address
First Line	:	1431 N. DELAWARE ST.
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202
Country	:	US
Telephone Number	:	317-536-7100
Fax Number	:	317-536-7101

Authorized Official
Title or Position	:	CEO
Name	:	MR. STEVEN MCCAFFREY
Credential	:	JD
Telephone Number	:	317-536-7100

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	10/23/2019

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