NPIMap

Organization Active NPI

Indiana Center for Recovery Outpatient Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carmel, IN
National Provider Identifier
1639869464
Registry record updated Nov 13, 2025
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
INDIANA CENTER FOR RECOVERY OUTPATIENT SERVICES LLC
Practice address
14555 Hazel Dell Pkwy Ste 140
Carmel, IN 46033-7234
Phone
(561) 305-0461
NPI assigned
May 15, 2023
Organization subpart
Yes
Parent organization
INDIANA CENTER FOR RECOVERY OUTPATIENT SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Authorized official

Name
Kirill Vesselov
Title
President
Phone
(561) 461-3791

Specialties & licenses 4

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
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

14555 Hazel Dell Pkwy Ste 140
Carmel, IN 46033-7234

Mailing address

14555 Hazel Dell Pkwy
Carmel, IN 46033-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240205001766 IN Part B Supplier - Clinic/Group Practice 3173966363 Receives reassigned benefits from 3 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Carmel, IN; Fort Wayne, IN; Jeffersonville, IN; Lafayette, IN; Merrillville, IN; Terre Haute, IN

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Indiana Center for Recovery Outpatient Services LLC6 organizations share this tax ID, including this one
Part of
Haven Detox Little Rock LLC

Other organizations with this tax ID 5

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

Locations

14555 Hazel Dell Pkwy
Carmel, IN 46033
Phone (317) 815-9310

3903 S 7th St
Ste 2A2
Terre Haute, IN 47802
Phone (812) 230-7281

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762992000000",
    "number": "1639869464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14555 HAZEL DELL PKWY",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460337000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14555 HAZEL DELL PKWY STE 140",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460337234",
            "telephone_number": "561-305-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANA CENTER FOR RECOVERY OUTPATIENT SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIANA CENTER FOR RECOVERY OUTPATIENT SERVICES LLC",
        "enumeration_date": "2023-05-15",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A",
        "authorized_official_last_name": "VESSELOV",
        "authorized_official_first_name": "KIRILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-461-3791"
    },
    "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": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carmel, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.