NPIMap

Organization Active NPI

Blue River Services, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Corydon, IN
National Provider Identifier
1902029259
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
281 McGrain St.
Corydon, IN 47112
Phone
(812) 738-7904
NPI assigned
Apr 11, 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

281 McGrain St.
Corydon, IN 47112

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
100385630 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 1902029259. Details of each certification follow.

  • CCN 15G611 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 15G611

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
Aug 26, 1991
Last certification
Mar 28, 2025
Beds
8
Ownership / control type
Private (non-profit)
Facility address
281 McGrain St
Corydon, IN 47112

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": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1902029259",
    "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": "281 MCGRAIN ST.",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "47112",
            "telephone_number": "812-738-7904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE RIVER SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "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": "100385630 A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corydon, IN

Sources for this page

Verify at the official NPI Registry.