FWBH, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

FWBH, LLC

Practice address

5680 Caito Dr Ste 114
Indianapolis, IN 46226-1392

Phone

(574) 381-7255

NPI assigned

Apr 8, 2026

Organization subpart

No

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

Authorized official

Name

Brian P. Farley

Title

Vice President & Secretary

Phone

(615) 861-6000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Hospital certification: CCN 154070

Legal name

FWBH LLC

Doing business as

MAPLE HEIGHTS BEHAVIORAL HEALTH

Certification status

Active

Provider type (POS)

Hospital – Psychiatric

Participating since

Apr 3, 2023

Last certification

Apr 3, 2023

Beds

120

Ownership / control type

Private (for profit)

Organization structure

LLCProprietary

Enrollment address

3955 W Washington Center Rd
Fort Wayne, IN 46818-1526
Main/Primary Hospital Location

Hospital subgroups

Psychiatric unit

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• FWBH, LLC

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1932843117

  O20221012001111

  Same enrollment

Listed as

Maple Heights Behavioral HealthCCN 154070

Type

Psychiatric

Ownership

Proprietary

Medicare certification status

ActiveFrom the Provider of Services file

Emergency services

Yes

Tax ID family

FWBH LLC2 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.

• FWBH, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1750100368
  NPD tax ID

Locations

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1285576249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 ASPEN GROVE DR STE 900",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370673134",
            "telephone_number": "615-861-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 CAITO DR STE 114",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462261392",
            "telephone_number": "574-381-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FWBH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "FARLEY",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "615-861-6000"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee Leeann Furrow
• Lyndsey Adams Furry, FNP
• Jessica A Furstenberg, ANP
• Kendra Renee Furtek, NP
• Cole Fuss
• G Gregory Clark MD and Anne C Clark MD Apc
• G.E. Widdifield, M.D.
• G&S Homecare LLC
• Sophia Lauren Gabaldon, CPT
• Chad S Gabbard, ATC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.