IndividualActive
Freddie Pegues
NPI 1497563084 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Indianapolis, IN
Provider details
- NPI number
- 1497563084
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
10021 Sundley Dr
Indianapolis, IN 46239-9057
Phone: (317) 448-3906
Approximate (ZIP-level) locationGet directions
Mailing address
10021 Sundley Dr
Indianapolis, IN 46239-9057
Registry dates
- Enumerated
- 2024-12-27
- Last updated
- 2024-12-27
- Certified
- 2024-12-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.