Provider Demographics
NPI:1902265267
Name:SUPPORTIVE COMMUNITY INNOVATIONS
Entity type:Organization
Organization Name:SUPPORTIVE COMMUNITY INNOVATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:F
Authorized Official - Last Name:KRUGGEL
Authorized Official - Suffix:IV
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:812-322-0313
Mailing Address - Street 1:9900 GILMORE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47448-9731
Mailing Address - Country:US
Mailing Address - Phone:812-322-0313
Mailing Address - Fax:
Practice Address - Street 1:9900 GILMORE RIDGE RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:IN
Practice Address - Zip Code:47448-9731
Practice Address - Country:US
Practice Address - Phone:812-322-0313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty