MEDICARE: YOUTH OUTLOOK 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1598034753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUTH OUTLOOK INC.

Provider Business Mailing Address
First Line	:	PO BOX 68196
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-0196
Country	:	US
Telephone Number	:	317-702-4348
Fax Number	:	317-295-0935

Provider Business Practice Location Address
First Line	:	4722 BLUFFWOOD DR N
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46228-2912
Country	:	US
Telephone Number	:	317-295-0900
Fax Number	:	317-295-0935

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. HUGH ANTONIO HUNTER
Credential	:
Telephone Number	:	317-702-4348

Provider Enumeration Date	:	12/17/2011
Last Update Date	:	01/03/2012

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