Provider Demographics
NPI:1841901022
Name:BE AUTHENTIC INDY LLC
Entity type:Organization
Organization Name:BE AUTHENTIC INDY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-241-6260
Mailing Address - Street 1:11005 THUNDERBIRD DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7912
Mailing Address - Country:US
Mailing Address - Phone:646-241-6260
Mailing Address - Fax:
Practice Address - Street 1:8606 ALLISONVILLE RD STE 120
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-3585
Practice Address - Country:US
Practice Address - Phone:317-548-8895
Practice Address - Fax:317-663-2524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty