Behaviorsource, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

34005028A Issued in IN

Legal business name

BEHAVIORSOURCE, LLC

Practice address

9425 N Meridian St
Suite 204
Indianapolis, IN 46260-1308

Phone

(317) 469-6347

Fax

(317) 580-9506

NPI assigned

Jan 11, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Timothy Dwain Adkins

Title

General Manager

Phone

(317) 469-6347

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1700116969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9425 N MERIDIAN ST",
            "address_2": "SUITE 204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601308",
            "telephone_number": "317-469-6347",
            "fax_number": "317-580-9506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9425 N MERIDIAN ST",
            "address_2": "SUITE 204",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601308",
            "telephone_number": "317-469-6347",
            "fax_number": "317-580-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORSOURCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "DWAIN",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "317-469-6347",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IN",
            "license": "34005028A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Community/Behavioral Health Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.