Rem Indiana

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

2524I0002DE08 Issued in IN

Legal business name

REM INDIANA

Doing business as

Indiana Mentor

Practice address

926 S 10TH St
Lafayette, IN 47905-1406

Phone

(765) 423-4280

NPI assigned

Mar 13, 2007

Last updated

Apr 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brett Ian Cohen

Title

Coos

Phone

(800) 388-5150

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Indiana Mentor Doing business as

Tax ID family

Rem Indiana Inc84 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Kokomo, IN
  • NPI 1497887574
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1528191467
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1609909449
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Carmel, IN
  • NPI 1609909456
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1629100805
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Peru, IN
  • NPI 1639201718
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Carmel, IN
  • NPI 1669504809
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1669504858
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Lafayette, IN
  • NPI 1740312966
  NPD tax ID
• Rem Indiana

  dba Indiana Mentor

  • Intellectual Disabilities Intermediate Care Facility
  • Logansport, IN
  • NPI 1740313774
  NPD tax ID
• Rem Indiana, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Versailles, IN
  • NPI 1457229874
  NPD tax ID
• Rem Indiana, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Jeffersonville, IN
  • NPI 1487500963
  NPD tax ID

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1659404622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 KEYSTONE XING STE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462402148",
            "telephone_number": "317-581-2380",
            "fax_number": "317-581-2378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 S 10TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479051406",
            "telephone_number": "765-423-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "COOS",
        "authorized_official_telephone_number": "800-388-5150"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "IN",
            "license": "2524I0002DE08",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "100249010",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indiana Mentor",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Indiana Mentor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelley Anne Reichelt, M.S. CCC-SLP
• Courtney Reinken
• Jill M. Reisman, PA
• John David Reisman, MD
• Rem Indiana (Indiana Mentor)
• Rem Indiana (Indiana Mentor)
• Rem Indiana (Indiana Mentor)
• Bethany Remaly, RBT
• Kristina Lynn Renfrow, FNP
• Arnold Robles Requierme, M.D.

• Intellectual Disabilities Intermediate Care Facility in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Intellectual Disabilities Intermediate Care Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.