Adec-Bridlewood

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

2670I0017JN08 Issued in IN

Legal business name

ADEC-BRIDLEWOOD

Practice address

58808 St Marys LN
Goshen, IN 46528-7623

Phone

(574) 848-7451

Fax

(574) 818-5917

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Paula M Shively

Title

Ceo

Phone

(574) 848-7451

Specialties & licenses 1

Addresses

Tax ID family

Adec Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

• Adec - Foster Avenue

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Elkhart, IN
  • NPI 1164646592
  NPD tax ID
• Adec - Goshen Men

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Goshen, IN
  • NPI 1871717223
  NPD tax ID
• Adec - Hawthorne

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Goshen, IN
  • NPI 1992929350
  NPD tax ID
• Adec - Middlebury Men

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Middlebury, IN
  • NPI 1164646527
  NPD tax ID
• Adec - Stevens Ave

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Elkhart, IN
  • NPI 1235353608
  NPD tax ID
• Adec - Terrace Park

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Goshen, IN
  • NPI 1598989964
  NPD tax ID
• Adec - Village Men

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Bristol, IN
  • NPI 1275757643
  NPD tax ID
• Adec - Village Women

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Bristol, IN
  • NPI 1710101183
  NPD tax ID
• Adec Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bristol, IN
  • NPI 1023307014
  NPD tax ID
• Adec Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bristol, IN
  • NPI 1114216108
  NPD tax ID
• Adec Inc

  • Developmentally Disabled Services Day Training Agency
  • Bristol, IN
  • NPI 1184777997
  NPD tax ID
• Adec Inc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Mishawaka, IN
  • NPI 1235432980
  NPD tax ID

Locations

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043434624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19670 SR 120",
            "city": "BRISTOL",
            "state": "IN",
            "postal_code": "465070398",
            "telephone_number": "574-848-7451",
            "fax_number": "574-848-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58808 ST MARYS LN",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465287623",
            "telephone_number": "574-848-7451",
            "fax_number": "574-818-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADEC-BRIDLEWOOD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIVELY",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-848-7451"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IN",
            "license": "2670I0017JN08",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Addiction Recovery Centers of Indiana, Incorporated
• Adec - Goshen Men
• Adec - Hawthorne
• Adec - Terrace Park
• Adec Inc - Ashley Court
• Bolanle Adeola Adepoju, M.D.
• Aegis Trusted Dentistry, P.C.
• Natalia Aguilar
• Matthew G Aitken
• Lynn J. Albrecht, D.D.S.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Goshen, IN
• Providers in Goshen, IN by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.