Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Identity Outreach Program Corp

Organization Case Management Agency · NPI 1043928187

Identity Outreach Program Corp is a Case Management Agency in Indianapolis, Indiana. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

7098 N Shadeland Ave Ste F
Indianapolis, IN 46220-4275
Phone: (317) 771-3006
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Child Intellectual and/or Developmental Disabilities Respite Care (primary) Taxonomy 385HR2060X
Case Management Agency Taxonomy 251B00000X

Record details

NPI number1043928187
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jasmine Tucker — Ceo/Founder · (317) 771-3006
NPI enumeratedNovember 8, 2022
Last updated in NPPESMarch 12, 2023
Certification dateMarch 12, 2023
Mailing address7098 N Shadeland Ave Ste F, Indianapolis, IN 46220-4275

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