180 DEGREES MENTORING GROUP (NPI# 1538640040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538640040 |
| Entity Type | Organization |
| Organization Name | 180 DEGREES MENTORING GROUP |
| Practice Address |
10608 Nassau St Indianapolis IN 46234-3183 |
| Practice Telephone | 3172501508 |
| Mailing Telephone | 3172501508 |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |
| Authorized Official Name | MR. CHARLES MAURICE SURRETT (CEO) |
| Authorized Official Telephone | 3172501508 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 373H00000X | Day Training/Habilitation Specialist | Nursing Service Related Providers |
| Street Address |
10608 NASSAU ST |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46234-3183 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275014789 | Charles Maurice Surrett | Day Training/Habilitation Specialist | 10608 Nassau St, Indianapolis, IN 46234-3183 | 2018-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619947 | Kyra Cooke | Registered Nurse | 5570 Goodwin St, Indianapolis, IN 46234 | 2020-11-06 |
| 1285241828 | Paris Janee Avant | Student in an Organized Health Care Education/Training Program | 8926 Mario Creek Dr, Indianapolis, IN 46234 | 2020-09-28 |
| 1316442072 | Ondrea Robinson | Counselor | 3636 N Raceway Rd, Suite 400, Indianapolis, IN 46234 | 2018-03-26 |
| 1629504303 | Life's Journey of Avon,llc | Hospice Care, Community Based | 10241 E. Co Rd 100 N., Indianapolis, IN 46234 | 2017-05-02 |
| 1235681776 | Michael Sundell | Specialist/Technologist | 9022 W 52nd St, Indianapolis, IN 46234 | 2016-11-01 |
| 1396033106 | Jill Carson Aldrich | Dentist | 10373 E County Road 100 N, Indianapolis, IN 46234 | 2011-07-13 |
| 1861603243 | Rodrigo Del Castillo Edo | Physical Therapist | 8616 West Tenth Street, Indianapolis, IN 46234 | 2007-05-25 |
| 1316072242 | Michael S. Miller Do, Facos, Cws, PC | Surgery | 8355 Rockville Rd # 120, Indianapolis, IN 46234 | 2007-02-22 |
| 1427114651 | Eagle Highland Pharmacy | Pharmacy | 9010 Crawfordsville Rd., Indianapolis, IN 46234 | 2006-12-30 |
| 1033166871 | Hendricks County Hospital | Skilled Nursing Facility | 8616 W 10th St, Indianapolis, IN 46234 | 2006-05-27 |
| Find all providers in zip 46234 | ||||
| Taxonomy Code | 373H00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Day Training/Habilitation Specialist |
| Individuals experienced or trained in working with developmentally disabled individuals who need assistance in acquiring and maintaining life skills that enable them to cope more effectively with the demands of independent living. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255976544 | Shenay Golden | Day Training/Habilitation Specialist | 9135 N Meridian St Ste B8, Indianapolis, IN 46260-1816 | 2019-11-11 |
| 1669031688 | Julia Phelps | Day Training/Habilitation Specialist | 1311 N Arlington Ave Ste 201, Indianapolis, IN 46219-3260 | 2019-06-12 |
| 1811453814 | Terry Anthony Webster Jr. | Day Training/Habilitation Specialist | 3710 Nuthatcher Dr, Indianapolis, IN 46228-1089 | 2019-02-14 |
| 1699240507 | Complete Tutoring & Mentoring LLC | Day Training/Habilitation Specialist | 8555 Cedar Place Dr Ste 112, Indianapolis, IN 46240-2344 | 2018-10-06 |
| 1275014789 | Charles Maurice Surrett | Day Training/Habilitation Specialist | 10608 Nassau St, Indianapolis, IN 46234-3183 | 2018-08-22 |
| 1851883102 | Kathy K Gates | Day Training/Habilitation Specialist | 1304 Mornington Dr, Indianapolis, IN 46239-8608 | 2018-06-02 |
| 1447658372 | Ike Boyd Jr. | Day Training/Habilitation Specialist | 1506 E 46th St, Indianapolis, IN 46205-2117 | 2014-12-09 |
| 1093067555 | Rachel D Taylor | Day Training/Habilitation Specialist | 6466 Bay Harbor Ln, Indianapolis, IN 46254-4514 | 2012-10-09 |
| 1700076098 | Michelle Lynn Conner | Day Training/Habilitation Specialist | 6144 Hanover Chase Ln, Indianapolis, IN 46239-1672 | 2007-08-01 |
| 1710018783 | Cassandra Elizabeth Crutchfield | Day Training/Habilitation Specialist | 8521 Sierra Ridge Dr, Apt. D, Indianapolis, IN 46239-8516 | 2007-03-08 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46234 |
Please comment or provide details below to improve the information on 180 DEGREES MENTORING GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.