NPIMap

Organization Active NPI

Children'S Therapy Innovations Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • South Bend, IN
National Provider Identifier
1407166192
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
CHILDREN'S THERAPY INNOVATIONS INC.
Practice address
2012 Ironwood Cir Ste 230
South Bend, IN 46635-1889
Phone
(574) 387-4049
Fax
(574) 387-4062
NPI assigned
Oct 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Authorized official

Name
Mrs. Lydia B Otiato, OTR
Title
President
Phone
(574) 387-4049

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X

Addresses

Primary practice location

2012 Ironwood Cir Ste 230
South Bend, IN 46635-1889

Mailing address

2012 Ironwood Cir Ste 230
South Bend, IN 46635-1889
Phone (574) 387-4049

Other identifiers 2

IdentifierTypeStateIssuer
201131520AMedicaidIN
201234930AMedicaidIN

Other names 1

  • CTI Aging and Rehabilitative Services Doing business as

National Provider Directory

National Provider Directory

Locations

2004 Ironwood Cir
Ste 110
South Bend, IN 46635
Phone (574) 387-4049

2012 Ironwood Cir
Ste 230
South Bend, IN 46635
Phone (574) 387-4049

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1407166192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 IRONWOOD CIR STE 230",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351889",
            "telephone_number": "574-387-4049",
            "fax_number": "574-387-4062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 IRONWOOD CIR STE 230",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351889",
            "telephone_number": "574-387-4049",
            "fax_number": "574-387-4062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S THERAPY INNOVATIONS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "OTIATO",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-387-4049",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201131520A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201234930A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CTI Aging and Rehabilitative Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CTI Aging and Rehabilitative Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.