OVERDOSE LIFELINE, INC. (NPI# 1215424692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215424692 |
| Entity Type | Organization |
| Organization Name | OVERDOSE LIFELINE, INC. |
| Other Organization Name | OVERDOSE LIFELINE, INC. |
| Practice Address |
1100 W 42nd St Ste 345 Indianapolis IN 46208-3345 |
| Practice Telephone | 8445543354 |
| Mailing Telephone | 8445543354 |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | MS. JUSTIN KAY PHILLIPS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3178286883 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 177F00000X | Lodging | Other Service Providers | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| N | 251V00000X | Voluntary or Charitable | Agencies | ||
| N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| N | 261QR0800X |
Clinic/Center Specialization: Recovery Care |
Ambulatory Health Care Facilities | ||
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Overdose Lifeline, Inc. | Former Legal Business Name - Organization |
| Street Address |
1100 W 42ND ST STE 345 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46208-3345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033650924 | Kristine M Sullivan | Dietitian, Registered | 2700 Doctor M.l.k. Jr St., Indianapolis, IN 46208 | 2017-03-13 |
| 1760877591 | Michael A. Davis, D.d.s. Family Dental LLC | Dentist | 3737 N. Meridian Ste. 410, Indianapolis, IN 46208 | 2015-03-30 |
| 1831432574 | Curtis Stennett | Psychiatry & Neurology | 563 W Westfield Blvd, Indianapolis, IN 46208 | 2013-04-01 |
| 1417206392 | Planned Parenthood of Indiana Midtown | Clinic/Center | 3750 N. Meridian St., Suite 100, Indianapolis, IN 46208 | 2012-09-06 |
| 1629216932 | Mary Carol Calloway Follman | Occupational Therapist | 5502 N. Kenwood Ave., Indianapolis, IN 46208 | 2009-01-23 |
| 1871760751 | Jacob Odell Roberts | Chiropractor | 2413 N Meridian St, Indianapolis, IN 46208 | 2008-05-10 |
| 1285846360 | Midwest Residential Services, Inc. | Preferred Provider Organization | 2425 N. Meridian Street, Suite B, Indianapolis, IN 46208 | 2007-05-03 |
| 1881814879 | Cheryl Ann Moore | Social Worker | 3171 N. Meridian Street, Indianapolis, IN 46208 | 2007-05-01 |
| 1679612881 | Kenneth Ackles Sr. | Chiropractor | 3231 North Meridian Street, Suite 502, Indianapolis, IN 46208 | 2007-02-05 |
| 1013062918 | William D. Alexy | Psychologist | 6110 N. Meridian, W.dr, Indianapolis, IN 46208 | 2007-01-24 |
| Find all providers in zip 46208 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
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| 1265915805 | Truth Treatment Center | Substance Abuse Rehabilitation Facility | 7150 Madison Ave, Indianapolis, IN 46227-5269 | 2018-09-10 |
| 1659851905 | The Salvation Army, An Illinois Corporation | Substance Abuse Rehabilitation Facility | 2400 N Tibbs Ave, Indianapolis, IN 46222-2458 | 2018-08-16 |
| 1629675012 | 8530 Township Line Road Opco LLC | Substance Abuse Rehabilitation Facility | 8530 Township Line Rd, Indianapolis, IN 46260-1927 | 2020-10-08 |
| 1710511068 | Landmark Recovery of Carmel, LLC | Substance Abuse Rehabilitation Facility | 6330 Digital Way, Indianapolis, IN 46278-1667 | 2020-02-26 |
| 1518507011 | Landmark Recovery of Indianapolis LLC | Substance Abuse Rehabilitation Facility | 6330 Digital Way, Indianapolis, IN 46278-1667 | 2020-01-13 |
| 1659913739 | Chosen Lawrence Manor LLC | Substance Abuse Rehabilitation Facility | 8935 E 46th St, Indianapolis, IN 46226-4125 | 2019-10-10 |
| 1164064242 | Chosen Capitol Village LLC | Substance Abuse Rehabilitation Facility | 2926 N Capitol Ave, Indianapolis, IN 46208-5131 | 2019-10-10 |
| 1700432341 | Newday Center | Substance Abuse Rehabilitation Facility | 6330 Digital Way, Indianapolis, IN 46278-1667 | 2019-08-09 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46208 |
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| 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.