Hoosier Uplands Economic Development Corporation
Organization Active NPI Adult Mental Health Clinic/Center · Bedford, IN
NPI 1376813147 · NPPES record last updated Jan 10, 2012
Key facts
- NPI
- 1376813147
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Mental Health Clinic/Center 261QM0850X
- Legal business name
- HOOSIER UPLANDS ECONOMIC DEVELOPMENT CORPORATION
- Practice address
- 2125 16TH St
Bedford, IN 47421-3003 - Phone
- (812) 275-4053
- NPI assigned
- Jan 10, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. David L. Miller
- Title
- Ceo
- Phone
- (812) 849-4447
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 4
Practitioners 15
-
John L Eckard, MD
-
Carrie Long, PMHNP
-
Thomas Andrew Trent, LCSW
-
Katelyn Lee, LMHC
-
John Mess, MS, LCACO
-
Emily Kuhfeld, LMHCA
-
Angela Marie Pohlen, LMHCA
-
Lisa Lynne Autry, M. S.W., A.C.S.W.
-
Marsha Mae Cummins, RN, CS, BC
-
Teryn McGlothlin, LMHC
-
Kaitlin Powell, LMHC, NCC
-
Kimberly Ann Schill, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Hoosier Uplands Home Health Care |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jun 10, 2009 Feb 13, 1980 |
| Hoosier Uplands Hospice |
Hospice | Operational/Managerial Control | Jun 10, 2009 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120222000487 | IN | Part B Supplier - Clinic/Group Practice | 4082767496 |
Receives reassigned benefits from 6 practitioners Practice locations: Bedford, IN |
National Provider Directory
- Tax ID family
- Hoosier Uplands Corporation
Locations
2125 16th St
Bedford, IN 47421
Phone (812) 275-4053
3710 Kenny Simpson Ln
Bedford, IN 47421
Phone (812) 243-2334
500 W Main St
Mitchell, IN 47446
Phone (812) 849-4447
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | Yes |
Addresses
Primary practice location
2125 16TH St
Bedford, IN 47421-3003
Mailing address
2125 16TH St
Bedford, IN 47421-3003
Phone (812) 275-4053
Other names
- Serenity Now Psychiatric & Counseling Services
Other providers in Bedford, IN
- Stephanie Dawn Holdcroft
- Hometown Personal Care, LLC
- Hook-Superx LLC
- Hoosier Family Practice P.C.
- Hoosier Helpers Senior Care, LLC
- Mary B Hoover
- Amanie Horkoss
- Rhys Horn
- Alexa Marie Howder
- Lindsey Howe
All providers in Bedford, IN · Adult Mental Health Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.