Organization Active NPI

Adec - Village Men

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Bristol, IN
National Provider Identifier
1275757643
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
2670I0004JN08 Issued in IN
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
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 Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

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.

Verify at the official NPI Registry.