MADISON CENTER, INC. (NPI# 1104974989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104974989 |
| Entity Type | Organization |
| Organization Name | MADISON CENTER, INC. |
| Practice Address |
403 E Madison St South Bend IN 46617-2322 |
| Practice Telephone | 5742310061 |
| Practice Fax Number | 5742831209 |
| Mailing Telephone | 5742310061 |
| Mailing Fax Number | 5742831209 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2010-04-07 |
| Authorized Official Name | BRENDA J CLANTON III (CONTRACTS MANAGER) |
| Authorized Official Telephone | 5742831107 |
| Is Organization Subpart | Y |
| Parent Organization Name | MADISON CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 406-1-PIP | IN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200495360A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265698120 | Madison Center, Inc. | Community/Behavioral Health | 403 E Madison St, South Bend, IN 46617-2322 | 2008-07-31 |
| 1750411872 | Madison Center, Inc. | Clinic/Center | 403 E Madison St, South Bend, IN 46617-2322 | 2007-03-07 |
| 1376691154 | Madison Center, Inc. | Clinic/Center | 403 E Madison St, South Bend, IN 46617-2322 | 2007-01-08 |
| 1174671952 | Madison Center, Inc. | Clinic/Center | 403 E Madison St, South Bend, IN 46617-2322 | 2007-01-08 |
| 1073565131 | Madison Center, Inc. | Psychiatric Hospital | 403 E Madison St, South Bend, IN 46617-2322 | 2006-05-17 |
| Street Address |
403 E MADISON ST |
| City | SOUTH BEND |
| State | IN |
| Zip Code | 46617-2322 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164497962 | Phillip Coffey | Social Worker | 403 E Madison St, South Bend, IN 46617-2322 | 2006-02-23 |
| 1134534456 | Memorial Hospital of South Bend, Inc | General Acute Care Hospital | 403 E Madison St, South Bend, IN 46617-2322 | 2014-06-25 |
| 1225310402 | Susan K Henderson | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2011-09-14 |
| 1154633550 | Meladie A Langham | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-07-14 |
| 1497067896 | Kami S Brenneman | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-07-14 |
| 1396064309 | Casandra Mcgrew | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-06-01 |
| 1124347133 | Amanda Jardine | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-06-01 |
| 1104141985 | Aaron T Gray | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2010-04-05 |
| 1346579679 | Linda S Hoppel | Counselor | 403 E Madison St, South Bend, IN 46617-2322 | 2009-12-16 |
| 1235468570 | Michelle M Peters | Social Worker | 403 E Madison St, South Bend, IN 46617-2322 | 2009-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740731116 | Jack Mcintyre Kimmell | Specialist/Technologist | 1526 East Lasalle, South Bend, IN 46617 | 2016-10-20 |
| 1023429115 | Morning View Assisted Living LLC | Assisted Living Facility | 475 N. Niles Avenue, South Bend, IN 46617 | 2014-05-12 |
| 1265861231 | Rebecca Busenbark | Physical Therapist | 401 E Colfax Ave Ste 102, South Bend, IN 46617 | 2013-11-11 |
| 1962709071 | Doreen Danice Huddleston | Social Worker | 928 East Wayne St, Suit C, South Bend, IN 46617 | 2011-02-25 |
| 1487981734 | Mary Cecilia Roemer | Marriage & Family Therapist | 616 E. Colfax Ave, South Bend, IN 46617 | 2009-11-06 |
| 1225264054 | Sridhar Meda | Dentist | 1005 East Lasalle Ave, South Bend, IN 46617 | 2009-06-08 |
| 1063673531 | Madeline Christina Watkins | Counselor | 616 E Colfax, South Bend, IN 46617 | 2008-06-18 |
| 1437366481 | Michael Reed Johns | Dentist | 103 South Eddy Street, South Bend, IN 46617 | 2007-05-17 |
| 1194937680 | Sarah Elizabeth Redman | Specialist/Technologist | 53880 Carmichael Dr., South Bend, IN 46617 | 2007-05-04 |
| 1124241211 | Trixy Franke | Family Medicine | 837 E. Cedar St., Ste 100, South Bend, IN 46617 | 2007-04-10 |
| Find all providers in zip 46617 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
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| 1518382993 | Patrick Mcneill | Psychiatric Residential Treatment Facility | 614 Farley Dr, Indianapolis, IN 46214-3575 | 2014-02-21 |
| 1063561272 | Associates In Clinical Psychology PC | Psychiatric Residential Treatment Facility | 317 West Monroe St, Plymouth, IN 46563 | 2007-01-09 |
| 1134276884 | Youth Opportunity Center, Inc | Psychiatric Residential Treatment Facility | 3700 W Kilgore Ave, Muncie, IN 47304-4810 | 2007-01-04 |
| 1982774246 | Gibault, Inc. | Psychiatric Residential Treatment Facility | 6401 S Us Highway 41, Terre Haute, IN 47802-4749 | 2006-11-08 |
| 1801822440 | Hhc Indiana Inc. | Psychiatric Residential Treatment Facility | 1800 N Oak Dr, Plymouth, IN 46563-3406 | 2006-06-24 |
| 1275080400 | Shirley Mclean | Psychiatric Residential Treatment Facility | 1100 W 6th Ave, Gary, IN 46402-1711 | 2016-09-06 |
| 1770970337 | Crossroad Child and Family Services | Psychiatric Residential Treatment Facility | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2015-04-22 |
| 1598194516 | Damar Services Inc. | Psychiatric Residential Treatment Facility | 6067 Decatur Blvd, Indianapolis, IN 46241-9606 | 2013-11-12 |
| 1730487901 | Gibault, Inc. | Psychiatric Residential Treatment Facility | 6401 S Us Highway 41, Terre Haute, IN 47802-4749 | 2011-03-11 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BEND |
| Zip Code | 46617 |
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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.