Active NPI
Adec - Village Men
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Bristol, IN
National Provider Identifier
1275757643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- License
- 2670I0004JN08
- Legal business name
- ADEC - VILLAGE MEN
- Practice address
- 19816 State Road 120 #3
Bristol, IN 46507 - Phone
- (574) 848-5751
- Fax
- (574) 848-5917
- NPI assigned
- Apr 13, 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
- Paula M Shively
- Title
- Ceo
- Phone
- (574) 848-7451
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | 2670I0004JN08 | IN | Primary |
Addresses
Primary practice location
19816 State Road 120 #3
Bristol, IN 46507
Mailing address
19670 St Rd 120
Bristol, IN 46507-0398
Phone (574) 848-7451
National Provider Directory
National Provider Directory- Tax ID family
- Adec Inc
Other organizations with this tax ID 23
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Elkhart, IN
- NPI 1164646592
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Goshen, IN
- NPI 1871717223
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Goshen, IN
- NPI 1992929350
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Middlebury, IN
- NPI 1164646527
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Elkhart, IN
- NPI 1235353608
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Goshen, IN
- NPI 1598989964
-
- Intellectual and/or Developmental Disabilities Residential Treatment Facility
- Bristol, IN
- NPI 1710101183
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Bristol, IN
- NPI 1023307014
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Bristol, IN
- NPI 1114216108
-
- Developmentally Disabled Services Day Training Agency
- Bristol, IN
- NPI 1184777997
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Mishawaka, IN
- NPI 1235432980
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Bristol, IN
- NPI 1326341074
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1275757643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19670 ST RD 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": "19816 STATE ROAD 120 #3",
"city": "BRISTOL",
"state": "IN",
"postal_code": "46507",
"telephone_number": "574-848-5751",
"fax_number": "574-848-5917"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADEC - VILLAGE MEN",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-13",
"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": "2670I0004JN08",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bristol, IN
Sources for this page
- 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.