NPIMap

Organization Active NPI

Blue River Services, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Salem, IN
National Provider Identifier
1740303973
Registry record updated May 3, 2013
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
BLUE RIVER SERVICES, INC.
Practice address
75 E. Oak Dr
Salem, IN 47167
Phone
(812) 883-4852
Fax
(812) 883-4852
NPI assigned
Apr 10, 2007
Last updated
May 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2013

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

Authorized official

Name
Daniel J Lowe
Title
President Ceo
Phone
(812) 738-2408

Specialties & licenses 1

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

Addresses

Primary practice location

75 E. Oak Dr
Salem, IN 47167

Mailing address

PO Box 547
Corydon, IN 47112-0547
Phone (812) 738-2408

Other identifiers 1

IdentifierTypeStateIssuer
100385640 AMedicaidIN

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 1740303973. Details of each certification follow.

  • CCN 15G289 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 15G289

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
BLUE RIVER SERVICES INC
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Nov 5, 1986
Last certification
Jun 12, 2025
Beds
8
Ownership / control type
Private (non-profit)
Facility address
75 East Oak Dr
Salem, IN 47167

National Provider Directory

National Provider Directory
Tax ID family
Blue River Services Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1740303973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471120547",
            "telephone_number": "812-738-2408",
            "fax_number": "812-738-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 E. OAK DR",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "47167",
            "telephone_number": "812-883-4852",
            "fax_number": "812-883-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIVER SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT  CEO",
        "authorized_official_telephone_number": "812-738-2408"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100385640 A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IN

Sources for this page

Verify at the official NPI Registry.