Individual provider · Type 1 NPI
Demetrius Whitehead, LPN
Physical Disabilities Residential Treatment Facility · Indianapolis, IN
NPI number
1346880341
Active
Practice location
415 S Butler Ave
Indianapolis, IN 46219-7034
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse | 164W00000X | 27060564A (IN) |
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | 21015321 (IN) |
| Physical Disabilities Residential Treatment Facility Primary | 320700000X | 21015321 (IN) |
Physical Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
Other physical disabilities residential treatment facility providers in Indianapolis
About NPI 1346880341
Demetrius Whitehead, LPN's National Provider Identifier is 1346880341, issued on Jan 8, 2020. The primary taxonomy on file is Physical Disabilities Residential Treatment Facility (320700000X), and the practice location is in Indianapolis, IN. The record was last updated on Feb 28, 2024.