Provider Demographics
NPI:1861531386
Name:ZIONSVILLE PRESBYTERIAN CHURCH
Entity type:Organization
Organization Name:ZIONSVILLE PRESBYTERIAN CHURCH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER THE CABIN
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:NOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-873-8140
Mailing Address - Street 1:4775 W 116TH STREET
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077
Mailing Address - Country:US
Mailing Address - Phone:317-873-6503
Mailing Address - Fax:
Practice Address - Street 1:4715 W 116TH STREET
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077
Practice Address - Country:US
Practice Address - Phone:317-873-8140
Practice Address - Fax:317-873-8141
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZIONSVILLE PRESBYTERIAN CHURCH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-05
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health