Organization Active NPI

Rayna'S Clubhouse Inc

  • Developmentally Disabled Services Day Training Agency
  • Indianapolis, IN
National Provider Identifier
1669308508
Registry record updated Jun 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
RAYNA'S CLUBHOUSE INC
Practice address
1445 Royal Lake Dr
Indianapolis, IN 46228-1380
Phone
(317) 308-0699
Fax
(317) 308-0699
NPI assigned
Jun 19, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2026

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

Authorized official

Name
Vivian Rae Brooks, BROOKS
Title
Ceo
Phone
(317) 308-0699

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

1445 Royal Lake Dr
Indianapolis, IN 46228-1380

Mailing address

1445 Royal Lake Dr
Indianapolis, IN 46228-1380
Phone (317) 308-0699

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1781827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781827200000",
    "number": "1669308508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 ROYAL LAKE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462281380",
            "telephone_number": "317-308-0699",
            "fax_number": "317-308-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 ROYAL LAKE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462281380",
            "telephone_number": "317-308-0699",
            "fax_number": "317-308-0699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYNA'S CLUBHOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-19",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-18",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-308-0699",
        "authorized_official_credential": "BROOKS"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; 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.