Organization Active NPI

Icr Outpatient Operating Subsidiary, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Terre Haute, IN
National Provider Identifier
1568311900
Registry record updated Jul 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ICR OUTPATIENT OPERATING SUBSIDIARY, LLC
Practice address
135 Hospital LN
Terre Haute, IN 47802-4247
Phone
(812) 645-3895
NPI assigned
Jan 27, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2026

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

Authorized official

Name
Tara Gurney
Title
Authorized Official
Phone
(561) 517-3400

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Mental Illness Community Based Residential Treatment Facility 320800000X
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

135 Hospital LN
Terre Haute, IN 47802-4247

Mailing address

2925 10TH Ave N
Palm Springs, FL 33461-3000

Other practice location 1

1578 E 85th Ave
Merrillville, IN 46410-8900
Phone (812) 645-3895

Other practice location 2

7900 W Jefferson Blvd Ste 300
Fort Wayne, IN 46804-4128
Phone (812) 645-3895

Other practice location 3

601 N Shore Dr
Jeffersonville, IN 47130-3142
Phone (812) 645-3895

Other practice location 4

2529 Schuyler Ave Ste 700
Lafayette, IN 47905-3982
Phone (812) 645-3895

Other practice location 5

14555 Hazel Dell Pkwy
Carmel, IN 46033-7000
Phone (812) 645-3895

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2288471Icr Outpatient Operating Subsidiary, LLC14555 Hazel Dell Parkway Suite 140, Carmel, IN 46033Certificate of waiverAug 24, 2027
15D2288475Icr Outpatient Operating Subsidiary, LLC601 North Shore Drive, Suite 102, Jeffersonville, IN 47130Certificate of waiverAug 24, 2027
15D2288476Icr Outpatient Operating Subsidiary, LLC1578 E 85TH Ave, Merrillville, IN 46410Certificate of waiverAug 24, 2027
15D2313563Icr Outpatient Operating Subsidiary, LLC135 E Hospital Lane, Terre Haute, IN 47802Certificate of waiverNov 3, 2026
15D2344462Icr Outpatient Operating Subsidiary, LLC7900 West Jefferson Blvd Suite 300, Fort Wayne, IN 46804Certificate of waiverMay 21, 2028
15D2344466Icr Outpatient Operating Subsidiary, LLC2529 Schuyler Avenue Suite 700, Lafayette, IN 47905Certificate of waiverMay 21, 2028

National Provider Directory

National Provider Directory

Locations

601 N Shore Dr
Jeffersonville, IN 47130
Phone (812) 207-2092

NPI Registry JSON

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

{
    "created_epoch": "1769472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785024000000",
    "number": "1568311900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 10TH AVE N",
            "city": "PALM SPRINGS",
            "state": "FL",
            "postal_code": "334613000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 HOSPITAL LN",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478024247",
            "telephone_number": "812-645-3895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1578 E 85th Ave",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464108900",
            "country_code": "US",
            "telephone_number": "812-645-3895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7900 W Jefferson Blvd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044128",
            "country_code": "US",
            "telephone_number": "812-645-3895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 N Shore Dr",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471303142",
            "country_code": "US",
            "telephone_number": "812-645-3895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2529 Schuyler Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "IN",
            "postal_code": "479053982",
            "country_code": "US",
            "telephone_number": "812-645-3895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14555 Hazel Dell Pkwy",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460337000",
            "country_code": "US",
            "telephone_number": "812-645-3895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICR OUTPATIENT OPERATING SUBSIDIARY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-27",
        "last_updated": "2026-07-26",
        "certification_date": "2026-07-26",
        "status": "A",
        "authorized_official_last_name": "GURNEY",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "561-517-3400"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2026; 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.