EAST INDIANA TREATMENT CENTER, LLC (NPI# 1013060714) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013060714 |
| Entity Type | Organization |
| Organization Name | EAST INDIANA TREATMENT CENTER, LLC |
| Practice Address |
816 Rudolph Way Greendale IN 47025-8312 |
| Mailing Address |
6185 Paseo Del Norte Ste 150 Carlsbad CA 92011-1155 |
| Practice Telephone | 8125371668 |
| Practice Fax Number | 8125371625 |
| Mailing Telephone | 7607100819 |
| Mailing Fax Number | 8125392368 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2018-07-31 |
| Authorized Official Name | PETER F MORRIS (PRESIDENT, CTC DIVISION) |
| Authorized Official Telephone | 6157211297 |
| Is Organization Subpart | Y |
| Parent Organization Name | ACADIA HEALTHCARE COMPANY, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
10780ASR | IN | Ambulatory Health Care Facilities |
| N | 261Q00000X | Clinic/Center | 10780ASR | IN | Ambulatory Health Care Facilities |
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
10780ASR | IN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0279713 | 05 | |
| IN | 201345410A | 05 | |
| IN | 3000012052 | 05 |
| Street Address |
816 RUDOLPH WAY |
| City | GREENDALE |
| State | IN |
| Zip Code | 47025-8312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508311291 | Sally Webster | Licensed Practical Nurse | 816 Rudolph Way, Greendale, IN 47025-8312 | 2016-08-23 |
| 1780139477 | Brenda Gullion | Licensed Practical Nurse | 816 Rudolph Way, Greendale, IN 47025-8312 | 2016-08-23 |
| 1558815639 | Mary Ann Detmer | Licensed Practical Nurse | 816 Rudolph Way, Greendale, IN 47025-8312 | 2016-08-07 |
| 1750834206 | Carolyn Richards | Registered Nurse | 816 Rudolph Way, Greendale, IN 47025-8312 | 2016-08-02 |
| 1659824886 | Vickie Hitchcock | Licensed Practical Nurse | 816 Rudolph Way, Greendale, IN 47025-8312 | 2016-07-23 |
| 1780055053 | East Indiana Comprehensive Treatment Center | Community/Behavioral Health | 816 Rudolph Way, Greendale, IN 47025-8312 | 2015-10-13 |
| 1932579901 | Leah Oelker | Counselor | 816 Rudolph Way, Greendale, IN 47025-8312 | 2015-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053761932 | Aimee Elizabeth Steele | Social Worker | 285 Bielby Rod, Lawrenceburg, IN 47025 | 2016-06-21 |
| 1942663703 | Kathryn Robinson | Speech-Language Pathologist | 478 Eagleview Drive, Lawrenceburg, IN 47025 | 2016-03-30 |
| 1518342674 | Emily Eichinger | Pharmacist | 401 W Eads Pkwy Ste 270, Greendale, IN 47025 | 2015-07-29 |
| 1104267269 | Bright Family Eye Care LLC | Optometrist | 24173 Stateline Rd., Suite 200, Lawrenceburg, IN 47025 | 2013-07-17 |
| 1912274333 | James J Gibbs | Pharmacist | 432 Craig Avenue, Greendale, IN 47025 | 2011-11-30 |
| 1265717755 | Carrie Rowekamp | Pharmacist | 432 Craig Ave., Greendale, IN 47025 | 2011-10-15 |
| 1619277621 | Whitner Counseling | Community/Behavioral Health | 5 Mary Street, Lawrenceburg, IN 47025 | 2010-10-25 |
| 1255646170 | Charles Alan Perine | Audiologist | 368 Bielby Rd Suite 140, Ludlow Hill Preofessional Bldg, Lawrenceburg, IN 47025 | 2010-08-16 |
| 1457579328 | Sei Physical Therapy, Inc. | Physical Therapist | 23990 Stateline Rd., Suite 1, Lawrenceburg, IN 47025 | 2007-04-23 |
| 1447382593 | Keith William Blankman | Optometrist | 19908 Augusta Dr, Suite 1, Lawrenceburg, IN 47025 | 2007-03-12 |
| Find all providers in zip 47025 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
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| 1134559917 | Center for Behavioral Health Indiana, Inc. | Clinic/Center | 3910 Lima Rd, Fort Wayne, IN 46805-1031 | 2013-11-15 |
| 1932732955 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 1110 W 5th Ave, Gary, IN 46402-1723 | 2020-02-18 |
| 1386159176 | The Otis R Bowen Center for Human Services Inc | Clinic/Center | 1415 Directors Row, Fort Wayne, IN 46808-1297 | 2017-12-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.