NPIMap

Organization Active NPI

Stone Belt Arc, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Bloomington, IN
National Provider Identifier
1639231897
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
00000704IDE07 Issued in IN
Legal business name
STONE BELT ARC, INC.
Practice address
4417 E Blackstone CT
Bloomington, IN 47408-3181
Phone
(812) 339-8284
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Authorized official

Name
Leslie Green
Title
Ceo
Phone
(812) 332-2168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 00000704IDE07 IN Primary

Addresses

Primary practice location

4417 E Blackstone CT
Bloomington, IN 47408-3181

Mailing address

2815 E 10TH St
Bloomington, IN 47408-2601

Other identifiers 1

IdentifierTypeStateIssuer
100234540MedicaidIN

National Provider Directory

National Provider Directory
Tax ID family
Stone Belt Arc Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1639231897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2815 E 10TH ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474082601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4417 E BLACKSTONE CT",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474083181",
            "telephone_number": "812-339-8284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE BELT ARC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-332-2168"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IN",
            "license": "00000704IDE07",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100234540",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.