INDIANA CENTER FOR RECOVERY, LLC (NPI# 1295276160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295276160 |
| Entity Type | Organization |
| Organization Name | INDIANA CENTER FOR RECOVERY, LLC |
| Practice Address |
1004 W 1st Street Bloomington IN 47403 |
| Practice Telephone | 8128222510 |
| Practice Fax Number | 8885163613 |
| Mailing Telephone | (812) 822-2510 |
| Mailing Fax Number | 8885163613 |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-08-03 |
| Authorized Official Name | MR. KIRILL VESSELOV (PRESIDENT) |
| Authorized Official Telephone | 7187303550 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | 1759-0ASO | IN | Residential Treatment Facilities |
| Street Address |
1004 W 1ST STREET |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| 1528369428 | Center for Optimal Health | Obstetrics & Gynecology | 415 W First Street, Bloomington, IN 47403 | 2010-11-09 |
| Find all providers in zip 47403 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568821940 | Guidance Treatment Home, LLC | Substance Abuse Rehabilitation Facility | 8735 Portland Ave S Apt 301, Bloomington, MN 55420-2961 | 2016-02-15 |
| 1710364450 | Social Science Services, Inc. | Substance Abuse Rehabilitation Facility | 10888 Maple Ave, Bloomington, CA 92316-2621 | 2015-05-01 |
| 1245781079 | Chestnut Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2016-10-17 |
| 1609021997 | Chestnut Health Systems | Substance Abuse Rehabilitation Facility | 1003 Martin Luther King Dr, Bloomington, IL 61701-1429 | 2008-12-01 |
| 1861648412 | Social Science Services, Inc. | Substance Abuse Rehabilitation Facility | 18612 Santa Ana Ave, Bloomington, CA 92316-2636 | 2008-08-14 |
| 1710103304 | Dorothy R Garnette | Substance Abuse Rehabilitation Facility | 18612 Santa Ana Ave, Bloomington, CA 92316-2636 | 2007-04-18 |
| 1548303480 | Social Science Services Inc. | Substance Abuse Rehabilitation Facility | 18612 Santa Ana Ave, Bloomington, CA 92316-2636 | 2007-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607597 | Momentum Kokomo, LLC | Substance Abuse Rehabilitation Facility | 1236 N. Wabash Ave, Kokomo, IN 46901 | 2020-10-23 |
| 1992304836 | Oasis Recovery, LLC | Substance Abuse Rehabilitation Facility | 2155 N 100 E, Tipton, IN 46072-8490 | 2020-10-21 |
| 1699302356 | Evolve Indy LLC | Substance Abuse Rehabilitation Facility | 8770 Guion Rd Ste B, Indianapolis, IN 46268-3017 | 2020-03-24 |
| 1366082091 | Celtic Recovery, LLC | Substance Abuse Rehabilitation Facility | 5660 Madison Ave, Indianapolis, IN 46227-4671 | 2020-01-10 |
| 1508408378 | Allendale LLC | Substance Abuse Rehabilitation Facility | 5419 County Road 427, Auburn, IN 46706-9504 | 2019-10-14 |
| 1154979615 | Pax Riverbend LLC | Substance Abuse Rehabilitation Facility | 1403 Spring St Ste 1, Jeffersonville, IN 47130-3736 | 2019-08-28 |
| 1578121547 | Landmark Recovery of Carmel, LLC | Substance Abuse Rehabilitation Facility | 13594 N Meridian St, Carmel, IN 46032-1698 | 2019-06-04 |
| 1881157329 | Grace Recovery and Wellness LLC | Substance Abuse Rehabilitation Facility | 3320 Main St Ste D, Anderson, IN 46013-4267 | 2019-04-11 |
| 1679035232 | Summit Bhc Henryvillle | Substance Abuse Rehabilitation Facility | 2602 Hebron Church Rd, Henryville, IN 47126-9021 | 2019-04-03 |
| 1457819195 | The Breakaway Corp | Substance Abuse Rehabilitation Facility | 1514 E Spring St, New Albany, IN 47150-2844 | 2019-03-12 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
Please comment or provide details below to improve the information on INDIANA CENTER FOR RECOVERY, LLC.
| 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.