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NPI Code Detail

MEDICARE: INDIANA CONNECTIONS ACADEMY, INC

MEDICARE: INDIANA CONNECTIONS ACADEMY, 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
1251300000XLocal Education Agency (LEA)

General Provider Information

NPI Number : 1982038741
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDIANA CONNECTIONS ACADEMY, INC
Provider Business Mailing Address
First Line : 6640 INTECH BLVD STE 250
Second Line : ATTN: CHRISTIE KESSLER
City : INDIANAPOLIS
State : IN
Zip : 46278-2018
Country : US
Telephone Number : 317-550-3188
Fax Number : 317-536-3532
Provider Business Practice Location Address
First Line : 6640 INTECH BLVD STE 250
Second Line : ATTN: CHRISTIE KESSLER
City : INDIANAPOLIS
State : IN
Zip : 46278-2018
Country : US
Telephone Number : 317-550-3188
Fax Number : 317-536-3532
Authorized Official
Title or Position : SUPERINTENDENT
Name : MELISSA BROWN
Credential :
Telephone Number : 317-667-0237
Provider Enumeration Date : 08/29/2013
Last Update Date : 08/29/2013

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Directions to “INDIANA CONNECTIONS ACADEMY, INC ” Practice Location

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