MEDICARE: DAMAR SERVICES 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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992801385
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAMAR SERVICES INC

Provider Business Mailing Address
First Line	:	PO BOX 41
Second Line	:
City	:	CAMBY
State	:	IN
Zip	:	46113-0041
Country	:	US
Telephone Number	:	317-856-5201
Fax Number	:	317-856-2333

Provider Business Practice Location Address
First Line	:	6324 KENTUCKY AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46221-9704
Country	:	US
Telephone Number	:	317-856-5201
Fax Number	:	317-856-2333

Authorized Official
Title or Position	:	CEO
Name	:	JIM L. DALTON
Credential	:
Telephone Number	:	317-281-4545

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	03/04/2020

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Directions to “DAMAR SERVICES INC ” Practice Location

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