MEDICARE: MARY RIGG NEIGHBORHOOD CENTER, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1629955406	OTHER	IN	CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS)

General Provider Information

NPI Number	:	1609755594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARY RIGG NEIGHBORHOOD CENTER, INC.

Provider Business Mailing Address
First Line	:	1920 W MORRIS ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46221-1540
Country	:	US
Telephone Number	:	463-900-4733
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 W MORRIS ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46221-1540
Country	:	US
Telephone Number	:	463-900-4733
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	LINDA KASSIS
Credential	:	MSW
Telephone Number	:	463-900-4733

Provider Enumeration Date	:	08/27/2025
Last Update Date	:	08/27/2025

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