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Demetrius Whitehead, LPN
Physical Disabilities Residential Treatment Facility in Indianapolis, Indiana
NPI 1346880341

Demetrius Whitehead is a Physical Disabilities Residential Treatment Facility based in Indianapolis, IN. Demetrius Whitehead practices in Indianapolis, IN and has the professional credentials of LPN. The NPI Number for Demetrius Whitehead is 1346880341 and holds a License No. 27060564A (Indiana).

The current practice location address for Demetrius Whitehead is 415 S Butler Ave, Indianapolis, IN and can be reached out via phone at 317-499-0437. You can also correspond with Demetrius Whitehead through the mailing address at 415 S BUTLER AVE, INDIANAPOLIS, IN - 46219-7034 (mailing address contact number: 317-409-1422).

Location: 415 S Butler Ave, Indianapolis, IN, 46219-7034
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346880341
Provider Name
Demetrius Whitehead
Credential
LPN
Provider Entity Type
Individual
Gender
Male
Address
415 S Butler Ave, Indianapolis, IN, 46219-7034
Phone Number
317-499-0437
Fax Number
Provider Enumeration Date
01/08/2020
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
415 S Butler Ave
City
Indianapolis
State
Indiana
Zip
46219-7034
Phone Number
317-499-0437
Fax Number
person
Provider Business Mailing Address Details
Address
415 S Butler Ave
City
Indianapolis
State
Indiana
Zip
46219-7034
Phone Number
317-409-1422
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Licensed Practical Nurse
Speciality
-
Taxonomy
164W00000X
License No.
21015321 (Indiana)
Definition
An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
21015321 (Indiana)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
person
Provider's Taxonomy Details 3
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Physical Disabilities
Speciality
-
Taxonomy
320700000X
License No.
27060564A (Indiana)
Definition
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.
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