| NPI | 1215424692 |
|---|---|
| Former Legal Business Name | OVERDOSE LIFELINE, INC. |
| Entity Type | Organization |
| Authorized Contact | JUSTIN KAY PHILLIPS Executive Director 317-828-6883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 177F00000X Lodging |
| 251B00000X Case Management | |
| 251S00000X Community/Behavioral Health | |
| 251V00000X Voluntary or Charitable | |
| 252Y00000X Early Intervention Provider Agency | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QM2800X Clinic/Center Methadone | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| 261QR0800X Clinic/Center Recovery Care | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2019-06-11 |