| Shared Space Llc | |
|
942 Maple Ave Noblesville IN 46060-2602 | |
| (317) 361-0962 | |
| Not Available |
| Full Name | Shared Space Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 942 Maple Ave, Noblesville, Indiana |
| Authorized Official Name and Position | Sharlie Patch-sablan (MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 3173610962 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shared Space Llc 5308 E 71st St Indianapolis IN 46220-3894 Ph: (317) 361-0962 | Shared Space Llc 942 Maple Ave Noblesville IN 46060-2602 Ph: (317) 361-0962 |
| NPI Number | 1366105884 |
|---|---|
| Provider Enumeration Date | 10/21/2021 |
| Last Update Date | 06/23/2023 |
| Certification Date | 06/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366105884 | NPI | - | NPPES |
| 300047038 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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