Angela Joann Yeend
Individual provider Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Manilla, IN
NPI 1295855989 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295855989
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- License
- 746576 (IN)
- Practice address
- 7012 S 725 W
Manilla, IN 46150-9713 - Phone
- (317) 512-0292
- Fax
- (765) 525-5849
- NPI assigned
- Mar 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 746576 | IN | MD | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | 746576 | IN | Yes |
Addresses
Primary practice location
7012 S 725 W
Manilla, IN 46150-9713
Mailing address
7012 S 725 W
Manilla, IN 46150-9713
Phone (317) 512-0292
Other providers in Manilla, IN
All providers in Manilla, IN · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.