NPIMap

Organization Active NPI

Bethlehem House Residence, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Indianapolis, IN
National Provider Identifier
1962779389
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
BETHLEHEM HOUSE RESIDENCE, INC
Practice address
130 E 30TH St
Indianapolis, IN 46205-3904
Phone
(317) 920-1519
Fax
(317) 920-1515
NPI assigned
Nov 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Authorized official

Name
Mr. Nathan L Rush
Title
Executive Director
Phone
(317) 920-1519

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Non-emergency Medical Transport (VAN) 343900000X
Private Vehicle 347C00000X

Addresses

Primary practice location

130 E 30TH St
Indianapolis, IN 46205-3904

Mailing address

130 E 30TH St
Indianapolis, IN 46205-3904
Phone (317) 920-1519

Other names 1

  • THE BETHLEHEM HOSUE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bethlehem House Residence2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1962779389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 30TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053904",
            "telephone_number": "317-920-1519",
            "fax_number": "317-920-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E 30TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053904",
            "telephone_number": "317-920-1519",
            "fax_number": "317-920-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHLEHEM HOUSE RESIDENCE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "317-920-1519",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE BETHLEHEM HOSUE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.