ZZ-INDIANAPOLIS VA DOMICILIARY (3663) INSTITUTION (4)

Name	Value
NAME	ZZ-INDIANAPOLIS VA DOMICILIARY
STATE	INDIANA
STREET ADDR. 1	725 NORTH PENNSYLVANIA ST
CITY	INDIANAPOLIS
ZIP	46204-1188
OFFICIAL VA NAME	INDIANAPOLIS VA DOMICILIARY
INACTIVE FACILITY FLAG	INACTIVE
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 10 PARENT FACILITY PARENT OF ASSOCIATION: RICHARD L. ROUDEBUSH VAMC
BILLING FACILITY NAME	INDIANAPOLIS VA CARE SITE
EFFECTIVE DATE/TIME	2015-09-01 00:00:00 STATUS: ACTIVE NPI: 1770943151
TAXONOMY CODE	Residential Treatment Facilities PRIMARY CODE: YES STATUS: INACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
STATION NUMBER	583BV
IDENTIFIER	CODING SYSTEM: CLIA ID: 99X9993000