NPIMap

Organization Active NPI

Center for Behavioral Health Indiana LLC

  • Methadone Clinic
  • Fort Wayne, IN
National Provider Identifier
1134559917
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
CENTER FOR BEHAVIORAL HEALTH INDIANA LLC
Practice address
3910 Lima Rd
Fort Wayne, IN 46805-1031
Phone
(260) 420-6010
NPI assigned
Nov 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Authorized official

Name
Jay Higham
Title
Ceo
Phone
(214) 365-6112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

Primary practice location

3910 Lima Rd
Fort Wayne, IN 46805-1031

Mailing address

5001 Spring Valley Road
Suite 600 East
Dallas, TX 75244-3946
Phone (214) 365-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200203000070 IN Part B Supplier - Opioid Treatment Program (Otp) 8921434473 Practice locations: Fort Wayne, IN

National Provider Directory

National Provider Directory
Tax ID family
Center for Behavioral Health Indiana2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

3910 Lima Rd
Fort Wayne, IN 46805
Phone (260) 420-6010

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735171200000",
    "number": "1134559917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 SPRING VALLEY ROAD",
            "address_2": "SUITE 600 EAST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443946",
            "telephone_number": "214-365-6100",
            "fax_number": "214-365-6150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 LIMA RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468051031",
            "telephone_number": "260-420-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR BEHAVIORAL HEALTH INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A",
        "authorized_official_last_name": "HIGHAM",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-365-6112"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.