NPIMap

Organization Active NPI

Park Center Inc

  • Psychiatric Hospital
  • Fort Wayne, IN
National Provider Identifier
1457772402
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
PARK CENTER INC
Practice address
1909 Carew St
Fort Wayne, IN 46805-4707
Phone
(260) 481-2809
Fax
(260) 481-2709
NPI assigned
Dec 18, 2013
Last updated
Mar 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Authorized official

Name
Mrs. Jessica Lee-Hansen
Title
Cfo
Phone
(312) 388-0125

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X NU
Psychiatric Hospital 283Q00000X NU Primary

Addresses

Primary practice location

1909 Carew St
Fort Wayne, IN 46805-4707

Mailing address

909 E State Blvd
Fort Wayne, IN 46805-3404
Phone (260) 481-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140211000906 IN Part A Provider - Hospital 5991794794 Practice locations: Columbia City, IN; Decatur, IN; Fort Wayne, IN; Huntington, IN; Bluffton, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457772402. Details of each certification follow.

Hospital certification: CCN 154060

Legal name
PARK CENTER INC
Doing business as
PARK CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Dec 5, 2014
Last certification
Dec 5, 2014
Beds
16
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Enrollment address
1909 Carew St
Fort Wayne, IN 46805-4707
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

  • Park Center Inc
    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Fort Wayne, IN
    • NPI 1306897004

    5991794794

    Same PAC ID

Care Compare: Hospital

Medicare Care Compare
Listed as
Park Center, IncCCN 154060 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Park Center Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

788 W Connexion Way
Columbia City, IN 46725

1610 Spy Run Ave
Fort Wayne, IN 46805
Phone (260) 423-2502

1909 Carew St
Fort Wayne, IN 46805
Phone (260) 481-2800

2700 Lafayette St
Ste 70
Fort Wayne, IN 46806

2710 Lake Ave
Fort Wayne, IN 46805
Phone (260) 373-8070

909 E State Blvd
Fort Wayne, IN 46805
Phone (260) 481-2718

26 Victory Noll Dr
Huntington, IN 46750
Phone (260) 355-3730

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Julie Meitzler Individual Operational/Managerial ControlBoard Member Jan 1, 2025
Stanton Stoppenhagen Individual Operational/Managerial ControlBoard Member Jan 1, 2025
Parkview Health System Inc Organization, Fort Wayne, IN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2021 100%
Taylor Vanover Individual Operational/Managerial ControlBoard Member Jan 1, 2025
Jessica Lee-Hansen Individual Corporate OfficerCfo Apr 22, 2026
W-2 Managing EmployeeAd; Apr 21, 2026
Tim Gall Individual Corporate Officer Oct 1, 2018
Jeremy Brown Individual Operational/Managerial ControlBoard Member Jan 1, 2025
Therese Brown Individual Operational/Managerial ControlBoard Member Jan 1, 2025
Greg R Johnson Individual Corporate Officer Oct 1, 2018
Wendy Davis Individual Operational/Managerial ControlBoard Member Jan 1, 2025
Ahsan Mahmood Individual W-2 Managing EmployeeService Line Leader - Behavioral He Jan 1, 2025
Operational/Managerial ControlBoard Member Jan 1, 2025
Dena Jacquay Individual Corporate OfficerCao Jan 1, 2025
W-2 Managing EmployeeAd; Jan 1, 2025
Mitchell B Stucky Individual Corporate OfficerCeo Designee Jan 1, 2026
W-2 Managing EmployeeAd; Jan 1, 2026
Richard Church Individual Corporate OfficerChief Growth & Strategy Officer Jan 1, 2025
W-2 Managing EmployeeAd; Jan 1, 2025

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

Practitioners & affiliated clinicians

Practitioners 115

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.

View all 115

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1457772402",
    "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": "1909 CAREW ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468054707",
            "telephone_number": "260-481-2809",
            "fax_number": "260-481-2709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "LEE-HANSEN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-388-0125",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.