MEDICARE: THOMAS CARR HOWE COMMUNITY HIGH SCHOOL

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1851721419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS CARR HOWE COMMUNITY HIGH SCHOOL

Provider Business Mailing Address
First Line	:	4900 JULIAN AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-3755
Country	:	US
Telephone Number	:	317-217-1980
Fax Number	:	317-217-1980

Provider Business Practice Location Address
First Line	:	4900 JULIAN AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-3755
Country	:	US
Telephone Number	:	317-217-1980
Fax Number	:	317-217-1980

Authorized Official
Title or Position	:	CHIEF ACADEMIC OFFICER
Name	:	MS. SHERRY A HAGE
Credential	:
Telephone Number	:	317-217-1980

Provider Enumeration Date	:	11/19/2013
Last Update Date	:	11/19/2013

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