Park Center, Inc.

Primary specialty

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

Legal business name

PARK CENTER, INC.

Practice address

809 High St
Decatur, IN 46733-2324

Phone

(260) 724-9669

Fax

(260) 724-4872

NPI assigned

Nov 22, 2011

Organization subpart

Yes

Parent organization

PARK CENTER, INC.As reported in NPPES

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

Authorized official

Name

Stanton Risser

Title

Acfo

Phone

(260) 266-9380

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Park Center Inc4 organizations share this tax ID, including this one

Part of

Park Center Inc

Other organizations with this tax ID 3

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

• Park Center Inc

  • Community/Behavioral Health Agency
  • Fort Wayne, IN
  • NPI 1073405270
  NPD tax ID
• Park Center Inc

  • Psychiatric Hospital
  • Fort Wayne, IN
  • NPI 1457772402
  NPD tax ID
• Park Center, Inc.

  • Community/Behavioral Health Agency
  • Fort Wayne, IN
  • NPI 1053594663
  NPD tax ID

Locations

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1366719171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 E STATE BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468053404",
            "telephone_number": "260-481-2700",
            "fax_number": "260-481-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 HIGH ST",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467332324",
            "telephone_number": "260-724-9669",
            "fax_number": "260-724-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK CENTER, INC.",
        "enumeration_date": "2011-11-22",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "RISSER",
        "authorized_official_first_name": "STANTON",
        "authorized_official_title_or_position": "ACFO",
        "authorized_official_telephone_number": "260-266-9380"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201033910A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Decatur, IN
• Providers in Decatur, 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 Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.