Rem Indiana

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

2524I0002DE08 Issued in IN

Legal business name

REM INDIANA

Practice address

124 Blackhawk LN
Lafayette, IN 47906-2019

Phone

(765) 463-2744

NPI assigned

Mar 12, 2007

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

Coo

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

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

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

  • Intellectual Disabilities Intermediate Care Facility
  • Lafayette, IN
  • NPI 1659404622
  NPD tax ID
• Rem Indiana

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

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

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

  • Intellectual Disabilities Intermediate Care Facility
  • Brownstown, IN
  • NPI 1750414710
  NPD tax ID
• Rem Indiana

  • Intellectual Disabilities Intermediate Care Facility
  • Greensburg, IN
  • NPI 1780717744
  NPD tax ID
• Rem Indiana

  • Intellectual Disabilities Intermediate Care Facility
  • Indianapolis, IN
  • NPI 1801929682
  NPD tax ID
• Rem Indiana

  • Intellectual Disabilities Intermediate Care Facility
  • Carmel, IN
  • NPI 1821121856
  NPD tax ID
• Rem Indiana

  • Intellectual Disabilities Intermediate Care Facility
  • North Vernon, IN
  • NPI 1821121880
  NPD tax ID
• Rem Indiana

  • Intellectual Disabilities Intermediate Care Facility
  • Carmel, IN
  • NPI 1841323698
  NPD tax ID

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1740312966",
    "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": "124 BLACKHAWK LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479062019",
            "telephone_number": "765-463-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM INDIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "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": "COO",
        "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": "100243500",
            "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"
        }
    ]
}

• Courtney Reinken
• Jill M. Reisman, PA
• John David Reisman, MD
• Rem Indiana
• Rem Indiana
• Rem Indiana
• Bethany Remaly, RBT
• Kristina Lynn Renfrow, FNP
• Arnold Robles Requierme, M.D.
• Shadi M Resheidat, MD

• All providers in Lafayette, IN
• 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.