NPIMap

Organization Active NPI

Valle Vista LLC

Doing business as Valle Vista Health System

  • Mental Health Counselor
  • Greenwood, IN
National Provider Identifier
1336300359
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3071PIP Issued in IN
Legal business name
VALLE VISTA LLC
Doing business as
Valle Vista Health System
Practice address
898 E Main St
Greenwood, IN 46143-1407
Phone
(317) 887-1348
Fax
(317) 885-9063
NPI assigned
Jun 23, 2008
Last updated
Jun 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Mr. Glenn David Bell Jr.
Title
Ceo
Phone
(317) 887-1348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3071PIP IN Primary

Addresses

Primary practice location

898 E Main St
Greenwood, IN 46143-1407

Mailing address

898 E Main St
Greenwood, IN 46143-1407
Phone (317) 887-1348

Other identifiers 1

IdentifierTypeStateIssuer
200139010AMedicaidIN

Other names 1

  • Valle Vista Health System Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Valle Vista Hospital Pharmacy5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

898 E Main St
Greenwood, IN 46143
Phone (317) 887-1348

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1336300359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "898 E MAIN ST",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431407",
            "telephone_number": "317-887-1348",
            "fax_number": "317-885-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "898 E MAIN ST",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431407",
            "telephone_number": "317-887-1348",
            "fax_number": "317-885-9063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLE VISTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-887-1348",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "3071PIP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200139010A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valle Vista Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.