| Limelight Recovery | |
|
8619 Lake Clearwater Lane Indianapolis IN 46240 | |
| (424) 234-2924 | |
| Not Available |
| Full Name | Limelight Recovery |
|---|---|
| Speciality | Social Worker |
| Location | 8619 Lake Clearwater Lane, Indianapolis, Indiana |
| Authorized Official Name and Position | Lawrence Owusu Fianko (CEO) |
| Authorized Official Contact | 4242342924 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Limelight Recovery 5325 E 82nd St Indianapolis IN 46250-4510 Ph: (812) 994-0902 | Limelight Recovery 8619 Lake Clearwater Lane Indianapolis IN 46240 Ph: (424) 234-2924 |
| NPI Number | 1245904754 |
|---|---|
| Provider Enumeration Date | 08/07/2021 |
| Last Update Date | 09/01/2023 |
| Certification Date | 09/01/2023 |
| Medicare PECOS PAC ID | 8921404294 |
|---|---|
| Medicare Enrollment ID | O20210913000366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245904754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Alyson Grider |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558943316 PECOS PAC ID: 4587072764 Enrollment ID: I20210428001744 |
| Provider Name | Joyce Audrey Fields |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124761101 PECOS PAC ID: 3779939186 Enrollment ID: I20231020002247 |
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