OrganizationActive
Identity Outreach Program Corp.
NPI 1043928187 · Child Intellectual and/or Developmental Disabilities Respite Care · Indianapolis, IN
Provider details
- NPI number
- 1043928187
- Entity type
- Organization
- Primary specialty
- Child Intellectual and/or Developmental Disabilities Respite CareRespite Care Facility
- Organization subpart
- No
- Authorized official
- Jasmine Tucker, Ceo/Founder(317) 771-3006
Specialties & taxonomies
Respite Care Facility
- Case Management Agency251B00000X
Agencies
Practice location
7098 N Shadeland Ave Ste F
Indianapolis, IN 46220-4275
Phone: (317) 771-3006
Approximate (ZIP-level) locationGet directions
Mailing address
7098 N Shadeland Ave Ste F
Indianapolis, IN 46220-4275
Registry dates
- Enumerated
- 2022-11-08
- Last updated
- 2023-03-12
- Certified
- 2023-03-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.