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Organization Active NPI

Rem Indiana

Doing business as Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
National Provider Identifier
1043343890
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
2524I0031DE08 Issued in IN
Legal business name
REM INDIANA
Doing business as
Indiana Mentor
Practice address
6338 Graham Rd
Indianapolis, IN 46220-4942
Phone
(317) 251-7102
NPI assigned
Mar 13, 2007
Last updated
Apr 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brett Ian Cohen
Title
Coo
Phone
(800) 388-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 2524I0031DE08 IN Primary

Addresses

Primary practice location

6338 Graham Rd
Indianapolis, IN 46220-4942

Mailing address

9000 Keystone Xing Ste 200
Indianapolis, IN 46240-2148
Phone (317) 581-2380

Other names 1

  • Indiana Mentor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Rem Indiana Inc84 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

9000 Keystone Xing
Ste 200
Indianapolis, IN 46240
Phone (317) 208-7713

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1043343890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 KEYSTONE XING STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462402148",
            "telephone_number": "317-581-2380",
            "fax_number": "317-581-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6338 GRAHAM RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462204942",
            "telephone_number": "317-251-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "800-388-5150"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IN",
            "license": "2524I0031DE08",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indiana Mentor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Indiana Mentor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.