Amicus Place, LLC.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

AMICUS PLACE, LLC.

Practice address

2427 Cedar BND
Anderson, IN 46011-1084

Phone

(765) 425-7794

NPI assigned

May 9, 2021

Last updated

May 9, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

George D Davidson Jr.

Title

Chief Executive Officer

Phone

(765) 425-7794

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1620518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620518400000",
    "number": "1770167405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2427 CEDAR BND",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460111084",
            "telephone_number": "765-425-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2427 CEDAR BND",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460111084",
            "telephone_number": "765-425-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMICUS PLACE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-09",
        "last_updated": "2021-05-09",
        "certification_date": "2021-05-09",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "765-425-7794",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "george@amicusplace.com",
            "affiliation": "N",
            "endpointDescription": "CEO email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2427 Cedar Bnd",
            "city": "Anderson",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460111084",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2021; 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.