NPIMap

Organization Active NPI

Rehabilitation Center Developmental Services, Inc.

Doing business as Fuquay Group Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Evansville, IN
National Provider Identifier
1730242843
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
REHABILITATION CENTER DEVELOPMENTAL SERVICES, INC.
Doing business as
Fuquay Group Home
Practice address
420 Fuquay Rd
Evansville, IN 47715-3718
Phone
(812) 479-1411
Fax
(812) 437-2636
NPI assigned
Dec 19, 2006
Last updated
Mar 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Mr. Fred G Miller
Title
Cfo and Treas
Phone
(812) 479-1411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

420 Fuquay Rd
Evansville, IN 47715-3718

Mailing address

3701 Bellemeade Ave
Evansville, IN 47714-0137
Phone (812) 479-1411

Other names 1

  • Fuquay Group Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730242843. Details of each certification follow.

  • CCN 15G379 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 15G379

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
REHABILITATION CENTER DEVELOPMENTAL SERVICES
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 19, 1987
Last certification
Aug 27, 2025
Beds
8
Ownership / control type
Private (non-profit)
Most recent change of ownership
Nov 24, 2008
Facility address
420 Fuquay Rd
Evansville, IN 47715

National Provider Directory

National Provider Directory
Tax ID family
Rehabilitation Center Developmental Services Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1730242843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 BELLEMEADE AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140137",
            "telephone_number": "812-479-1411",
            "fax_number": "812-437-2636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 FUQUAY RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477153718",
            "telephone_number": "812-479-1411",
            "fax_number": "812-437-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION CENTER DEVELOPMENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CFO AND TREAS",
        "authorized_official_telephone_number": "812-479-1411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fuquay Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.