Sequel Tsi of Indiana, LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

SEQUEL TSI OF INDIANA, LLC

Doing business as

Englishton Park

Practice address

2426 S Parker LN
Lexington, IN 47138-8561

Phone

(812) 889-3992

Fax

(812) 889-3990

NPI assigned

Dec 29, 2009

Organization subpart

No

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

Authorized official

Name

Mr. John Stupak

Title

President

Phone

(267) 419-8913

Specialties & licenses 1

Addresses

Other names 1

• Englishton Park Doing business as

Locations

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1356671192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2426 S PARKER LN",
            "city": "LEXINGTON",
            "state": "IN",
            "postal_code": "471388561",
            "telephone_number": "812-889-3992",
            "fax_number": "812-889-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2426 S PARKER LN",
            "city": "LEXINGTON",
            "state": "IN",
            "postal_code": "471388561",
            "telephone_number": "812-889-3992",
            "fax_number": "812-889-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUEL TSI OF INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "STUPAK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-419-8913",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Englishton Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alisa Rae Cox, LCSW
• Sherry M Cox
• Heather K. M. Crites, FNP-C
• Darla M Dabney
• Joanna Gullion, NP
• Paula D. Stoner
• Malissa Truman, LSW
• Elizabeth Webber

• Emotionally Disturbed Childrens' Residential Treatment Facility in Lexington, IN
• Providers in Lexington, IN by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.