NPIMap

Organization Active NPI

The Arc of Northeast Indiana, Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Fort Wayne, IN
National Provider Identifier
1336202167
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
2602I0003JN08 Issued in IN
Legal business name
THE ARC OF NORTHEAST INDIANA, INC
Practice address
4422 Lake Avenue
Fort Wayne, IN 46815-7224
Phone
(260) 456-4534
Fax
(260) 745-5200
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Ms. Donna Kristeen Elbrecht
Title
Ceo/President
Phone
(260) 456-4534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 2602I0003JN08 IN Primary

Addresses

Primary practice location

4422 Lake Avenue
Fort Wayne, IN 46815-7224

Mailing address

4919 Coldwater Rd.
Fort Wayne, IN 46825-5532
Phone (260) 456-4534

Other identifiers 1

IdentifierTypeStateIssuer
100233750MedicaidIN

Other names 2

  • Easter Seals ARC of Northeast Indiana Doing business as
  • Easterseals ARC of Northeast Indiana, Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 15G075

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
EASTER SEALS ARC OF NORTHEAST
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jun 3, 1982
Last certification
Dec 8, 2025
Beds
8
Ownership / control type
Private (non-profit)
Facility address
4422 Lake Ave
Fort Wayne, IN 46815

National Provider Directory

National Provider Directory
Tax ID family
The Arc of Northeast Indiana Inc14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1336202167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4919 COLDWATER RD.",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468255532",
            "telephone_number": "260-456-4534",
            "fax_number": "260-745-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4422 LAKE AVENUE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468157224",
            "telephone_number": "260-456-4534",
            "fax_number": "260-745-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ARC OF NORTHEAST INDIANA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "ELBRECHT",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "KRISTEEN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "260-456-4534",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IN",
            "license": "2602I0003JN08",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100233750",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Easter Seals ARC of Northeast Indiana",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Easterseals ARC of Northeast Indiana, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.