Rem Indiana

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

25240001DE08 Issued in IN

Legal business name

REM INDIANA

Doing business as

Indiana Mentor

Practice address

1221 Warren Dr
Lafayette, IN 47905-2122

Phone

(765) 474-9895

NPI assigned

Mar 12, 2007

Last updated

Apr 18, 2023By the provider in NPPES

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Indiana Mentor Doing business as

Tax ID family

Rem Indiana Inc84 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

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

• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1043343890
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1114059441
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1134252984
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Merrillville, IN
  • NPI 1154454106
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1164554424
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1194858142
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1225161078
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1235261603
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1235262155
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1255463493
  NPD tax ID
• Rem Indiana, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Bedford, IN
  • NPI 1003762485
  NPD tax ID
• Rem Indiana, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Bedford, IN
  • NPI 1003784422
  NPD tax ID

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1144352352",
    "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": "1221 WARREN DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479052122",
            "telephone_number": "765-474-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "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": "25240001DE08",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "100243370",
            "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"
        }
    ]
}

• Stanton Maurice Regan, M.D.
• Shelley Anne Reichelt, M.S. CCC-SLP
• Courtney Reinken
• Jill M. Reisman, PA
• John David Reisman, MD
• Rem Indiana (Indiana Mentor)
• Rem Indiana (Indiana Mentor)
• Rem Indiana (Indiana Mentor)
• Bethany Remaly, RBT
• Kristina Lynn Renfrow, FNP

• Intellectual Disabilities Intermediate Care Facility in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Intellectual Disabilities Intermediate Care Facility in Indiana

• 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.