Provider Demographics
NPI:1427154814
Name:DAMAR SERVICES INC
Entity type:Organization
Organization Name:DAMAR SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:L
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-281-4545
Mailing Address - Street 1:6067 DECATUR BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46241-9606
Mailing Address - Country:US
Mailing Address - Phone:317-856-5201
Mailing Address - Fax:317-856-2333
Practice Address - Street 1:6067 DECATUR BLVD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-9606
Practice Address - Country:US
Practice Address - Phone:317-856-5201
Practice Address - Fax:317-856-2333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300011498Medicaid
IN300046999Medicaid
IN300086681Medicaid
IN300015288Medicaid
IN300019912Medicaid
IN200437920AMedicaid
IN300093086Medicaid
IN200437920CMedicaid
IN300020167Medicaid
IN300066992Medicaid
IN200437920BMedicaid
IN300014736Medicaid
IN300018560Medicaid
IN300020100Medicaid
IN300014451Medicaid