Rem Indiana Community Service II, Inc.

Primary specialty

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

License

200300350 Issued in IN

Legal business name

REM INDIANA COMMUNITY SERVICE II, INC.

Practice address

8925 N Meridian St
Suite 200
Indianapolis, IN 46260-2386

Phone

(317) 581-2380

Fax

(317) 581-2378

NPI assigned

Mar 15, 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

• Indana Mentor Other name

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682121600000",
    "number": "1932233764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8925 N MERIDIAN ST",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602386",
            "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": "8925 N MERIDIAN ST",
            "address_2": "SUITE 200",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602386",
            "telephone_number": "317-581-2380",
            "fax_number": "317-581-2378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REM INDIANA COMMUNITY SERVICE II, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2023-04-22",
        "certification_date": "2023-04-22",
        "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": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "IN",
            "license": "200300350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200300350",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Indana Mentor",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Indana Mentor",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rem Indiana
• Rem Indiana
• Rem Indiana
• Rem Indiana
• Rem Indiana
• Rem Indiana Community Services
• Rem Indiana Community Services
• Rem Indiana, Inc.
• Rem Indiana, Inc.
• Rem Indiana, Inc.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.