OrganizationActive
Care Access Group, Inc-Waiver Services
NPI 1902547136 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Indianapolis, IN
Provider details
- NPI number
- 1902547136
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Shvonne Watson, Ceo(317) 213-7975
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
4151 E 40th Street South Dr
Indianapolis, IN 46226-4415
Phone: (317) 213-7975
Approximate (ZIP-level) locationGet directions
Mailing address
4151 E 40th Street South Dr
Indianapolis, IN 46226-4415
Registry dates
- Enumerated
- 2022-04-03
- Last updated
- 2022-04-03
- Certified
- 2022-04-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.