Active NPI
Rem Indiana Community Services
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Indianapolis, IN
National Provider Identifier
1073645487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- License
- 100249260
- Legal business name
- REM INDIANA COMMUNITY SERVICES
- Practice address
- 8925 N Meridian St
Suite 200
Indianapolis, IN 46260-2386 - Phone
- (317) 581-2380
- Fax
- (317) 581-2378
- NPI assigned
- Mar 12, 2007
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | 100249260 | IN | Primary |
Addresses
Primary practice location
8925 N Meridian St
Suite 200
Indianapolis, IN 46260-2386
Mailing address
9000 Keystone Xing Ste 200
Indianapolis, IN 46240-2148
Phone (317) 581-2380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100249260 | Other | IN | PROVIDER NUMBER |
Other names 1
- Indiana Mentor
National Provider Directory
National Provider Directory- Tax ID family
- Indiana Mentor
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Developmental Disabilities Clinic/Center
- Indianapolis, IN
- NPI 1043885304
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1681948800000",
"number": "1073645487",
"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": "8925 N MERIDIAN ST",
"address_2": "SUITE 200",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462602386",
"telephone_number": "317-581-2380",
"fax_number": "317-581-2378"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REM INDIANA COMMUNITY SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-12",
"last_updated": "2023-04-20",
"certification_date": "2023-04-20",
"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": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": "IN",
"license": "100249260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBER",
"identifier": "100249260",
"state": "IN"
}
],
"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 20, 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.