Impact & Rebuild Wellness & Behavioral Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

IMPACT & REBUILD WELLNESS & BEHAVIORAL SERVICES LLC

Practice address

10928 Spring Green Dr
Indianapolis, IN 46229-3536

Phone

(317) 397-5845

NPI assigned

Sep 11, 2026

Organization subpart

No

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

Authorized official

Name

Mr. Raymond Edward Fisher Sr.

Title

Founder/Ceo

Phone

(317) 397-5845

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1789084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789084800000",
    "number": "1780594739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10928 SPRING GREEN DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462293536",
            "telephone_number": "317-397-5845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10928 SPRING GREEN DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462293536",
            "telephone_number": "317-397-5845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT & REBUILD WELLNESS & BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-11",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "317-397-5845",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.