NPIMap

Organization Active NPI

Coach Dreammakers LLC

  • Community/Behavioral Health Agency
  • Indianapolis, IN
National Provider Identifier
1194121541
Registry record updated Nov 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
2330496686 Issued in IN
Legal business name
COACH DREAMMAKERS LLC
Practice address
5626 Portwood PL
Indianapolis, IN 46254-5140
Phone
(317) 513-2386
NPI assigned
Nov 13, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ricky Buckley
Title
Owner
Phone
(317) 513-2386

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 2330496686 IN Primary

Addresses

Primary practice location

5626 Portwood PL
Indianapolis, IN 46254-5140

Mailing address

5626 Portwood PL
Indianapolis, IN 46254-5140
Phone (317) 513-2386

National Provider Directory

National Provider Directory
Tax ID family
Coach Dreammakers LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415836800000",
    "number": "1194121541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 PORTWOOD PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545140",
            "telephone_number": "317-513-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5626 PORTWOOD PL",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545140",
            "telephone_number": "317-513-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COACH DREAMMAKERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-13",
        "last_updated": "2014-11-13",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-513-2386"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "2330496686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.