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Rem Indiana

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Indianapolis, IN

NPI 1235262155 · NPPES record last updated Apr 18, 2023

Key facts

NPI
1235262155
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
2524I0013JN08 (IN)
Legal business name
REM INDIANA
Practice address
4002 Moller Rd
Indianapolis, IN 46254-2934
Phone
(317) 297-3860
NPI assigned
Mar 13, 2007
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Rem Indiana Inc (84 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 2524I0013JN08 IN Yes

Addresses

Primary practice location

4002 Moller Rd
Indianapolis, IN 46254-2934

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
100244290OtherINPROVIDER NUMBER

Other names

  • Indiana Mentor Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 18, 2023.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1235262155",
    "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": "4002 MOLLER RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462542934",
            "telephone_number": "317-297-3860"
        }
    ],
    "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": "2524I0013JN08",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "100244290",
            "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

All providers in Indianapolis, IN · Intellectual Disabilities Intermediate Care Facility in Indiana

Sources for this page

Verify at the official NPI Registry.