ENLIGHTENMENT & WELLNESS LLC


Address: 910 N Shadeland Ave Ste 11, Indianapolis, IN 46219-4810
Phone: 3174417625

ENLIGHTENMENT & WELLNESS LLC (NPI# 1144789496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144789496
Entity Type Organization
Organization Name ENLIGHTENMENT & WELLNESS LLC
Practice Address 910 N Shadeland Ave Ste 11
Indianapolis
IN 46219-4810
Mailing Address 6062 Countrybrook Rd
Indianapolis
IN 46254-1262
Practice Telephone 3174417625
Mailing Telephone 7657270990
Enumeration Date 2019-03-17
Last Update Date 2019-03-17
Authorized Official Name MS. BARBARA J HUMPHREY (THERAPIST)
Authorized Official Telephone 7657270990
Authorized Official Credential MA, LCAC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Enlightenment & Wellness,LLC Doing Business As Name - Organization

Provider Secondary Practice Location

Address Telephone Number Fax Number
5422 N Keystone Ave, Indianapolis, IN 462203456 3172033344

Other Data Sources

Entity Type Entity Name Entity Address
Indiana Business Entities ENLIGHTENMENT & WELLNESS LLC 6062 Countrybrook Road, Indianapolis, IN 46254

Office Location

Street Address 910 N SHADELAND AVE STE 11
City INDIANAPOLIS
State IN
Zip Code 46219-4810

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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

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Competitor

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City INDIANAPOLIS
Zip Code 46219

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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