Provider Demographics
NPI:1124466131
Name:ADDICTION CARE INTERVENTIONS INC
Entity type:Organization
Organization Name:ADDICTION CARE INTERVENTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:LSW, LCAC
Authorized Official - Phone:317-738-0515
Mailing Address - Street 1:550 E. JEFFERSON AVE.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131
Mailing Address - Country:US
Mailing Address - Phone:317-738-0515
Mailing Address - Fax:317-883-4014
Practice Address - Street 1:550 E. JEFFERSON AVE.
Practice Address - Street 2:SUITE 101
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131
Practice Address - Country:US
Practice Address - Phone:317-738-0515
Practice Address - Fax:317-883-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87000021A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health