MEDICARE: FAMILY LINKS RESIDENTIAL LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1487506291
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY LINKS RESIDENTIAL LLC

Provider Business Mailing Address
First Line	:	1937 E 30TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-2608
Country	:	US
Telephone Number	:	317-250-0443
Fax Number	:

Provider Business Practice Location Address
First Line	:	1937 E 30TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46218-2608
Country	:	US
Telephone Number	:	317-250-0443
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER/DIRECTOR
Name	:	ANTHONY DOUTHIT JR.
Credential	:
Telephone Number	:	317-250-0443

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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