MEDICARE: GUIDANCE LIFE-SKILLS AND MENTORING 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	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1407714215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDANCE LIFE-SKILLS AND MENTORING INC.

Provider Business Mailing Address
First Line	:	PO BOX 88321
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-0321
Country	:	US
Telephone Number	:	317-500-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3720 N EUCLID AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-1518
Country	:	US
Telephone Number	:	317-500-2800
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	SHANEL POOLE
Credential	:
Telephone Number	:	317-500-2800

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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