OrganizationActive
180 Enterprise
NPI 1619564549 · Addiction (Substance Use Disorder) Counselor · Indianapolis, IN
Provider details
- NPI number
- 1619564549
- Entity type
- Organization
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Kimtoiya Sam, Owner(317) 966-7772
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
3430 Cork Bend Dr
Indianapolis, IN 46239-7669
Phone: (317) 966-7772
Approximate (ZIP-level) locationGet directions
Mailing address
3430 Cork Bend Dr
Indianapolis, IN 46239-7669
Registry dates
- Enumerated
- 2020-12-27
- Last updated
- 2020-12-27
- Certified
- 2020-12-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.