Icr Operating Subsidiary, LLC

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

Legal business name

ICR OPERATING SUBSIDIARY, LLC

Practice address

1004 W 1St St
Bloomington, IN 47403-2208

Phone

(812) 393-5596

NPI assigned

Jan 29, 2026

Organization subpart

No

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 4

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1769644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1629928767",
    "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": "1004 W 1ST ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032208",
            "telephone_number": "812-393-5596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 W 1st St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032274",
            "country_code": "US",
            "telephone_number": "812-393-5596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "637 S Walker St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032175",
            "country_code": "US",
            "telephone_number": "812-393-5596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 W 1st St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032208",
            "country_code": "US",
            "telephone_number": "812-393-5596",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "421 W 1st St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474032403",
            "country_code": "US",
            "telephone_number": "812-393-5596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ICR OPERATING SUBSIDIARY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-29",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "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": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "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": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Huynh, PHARM.D.
• Denise Hyble, LMFT
• Stephanie Hyten
• I-Care Bloomington Inc
• Ahmed Ibrahim, MD
• Ilic Renal and Hypertension Associates, P.a.
• Ljubomir M Ilic, MD
• Dwain Clark Illman, M.D.
• Ima East Primary Care
• Ima Inc Laboratory

• Psychiatric Residential Treatment Facility in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Psychiatric Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.