PARK CENTER, INC. (NPI# 1366719171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366719171 |
| Entity Type | Organization |
| Organization Name | PARK CENTER, INC. |
| Practice Address |
809 High St Decatur IN 46733-2324 |
| Mailing Address |
909 E State Blvd Fort Wayne IN 46805-3404 |
| Practice Telephone | 2607249669 |
| Practice Fax Number | 2607244872 |
| Mailing Telephone | 2604812700 |
| Mailing Fax Number | 2604812709 |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2011-11-22 |
| Authorized Official Name | PAUL WILSON (PRESIDENT & CEO) |
| Authorized Official Telephone | 2604812700 |
| Authorized Official Credential | MSSW, MHA |
| Is Organization Subpart | Y |
| Parent Organization Name | PARK CENTER, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201033910A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053594663 | Park Center, Inc. | Community/Behavioral Health | 909 E State Blvd, Fort Wayne, IN 46805-3404 | 2007-12-06 |
| Street Address |
809 HIGH ST |
| City | DECATUR |
| State | IN |
| Zip Code | 46733-2324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154951564 | Tyler Connolly | Counselor | 809 High St, Decatur, IN 46733-2324 | 2020-01-24 |
| 1437789930 | Joshua A Kaufmann | Case Manager/Care Coordinator | 809 High St, Decatur, IN 46733-2324 | 2020-01-23 |
| 1275099376 | Karla A Lipsey | Counselor | 809 High St, Decatur, IN 46733-2324 | 2019-02-13 |
| 1134609266 | Amy L Shaw | Case Manager/Care Coordinator | 809 High St, Decatur, IN 46733-2324 | 2018-08-17 |
| 1275013302 | Sabra Ann Vanauken | Counselor | 809 High St, Decatur, IN 46733-2324 | 2018-08-17 |
| 1588140560 | Megan Elizabeth Mullet | Counselor | 809 High St, Decatur, IN 46733-2324 | 2018-07-13 |
| 1235659632 | Keri Ellen Mccall | Counselor | 809 High St, Decatur, IN 46733-2324 | 2017-06-27 |
| 1720497548 | Katlyn Smith | Counselor | 809 High St, Decatur, IN 46733-2324 | 2014-08-06 |
| 1508290453 | Robert Michael Corral | Marriage & Family Therapist | 809 High St, Decatur, IN 46733-2324 | 2013-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659742617 | Adams County Auditor | Public Health or Welfare | 313 W. Jefferson St., Room # 320, Decatur, IN 46733 | 2015-10-15 |
| 1184908386 | Logan D Anderson | Pharmacist | 123 N. 13th St, Decatur, IN 46733 | 2011-10-06 |
| 1992091797 | Leah D Keller | Social Worker | 815 High St Ste C, Decatur, IN 46733 | 2011-06-21 |
| 1144559493 | Preble Volunteer Firefighting Association, Inc. | Ambulance | 6242 N 400 W, Decatur, IN 46733 | 2009-12-16 |
| 1689703530 | Blake A Taylor | Dentist | 234 N First St, Decatur, IN 46733 | 2007-03-05 |
| 1124163563 | Decatur Dental Services,, Inc. | Dentist | Decatur, 6496 N Piqua Road, Decatur, IN 46733 | 2007-02-21 |
| 1215002597 | Kelly S Ulman | Dentist | 6496 N Piqua Rd, Decatur, IN 46733 | 2006-11-21 |
| 1841362712 | James E Taylor Dds and Associates Family Dentistry | Dentist | 234 N 1st St, Decatur, IN 46733 | 2006-11-15 |
| 1598844946 | Michael Alan Harshman | Optometrist | 815 South 13th St., Decatur, IN 46733 | 2006-11-06 |
| 1376043752 | Adams County Memorial Hospital | Clinic/Center | 1100 Mercer Ave, Decatur, IN 46733 | 2018-02-13 |
| Find all providers in zip 46733 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1245889609 | Sunshine Mental Wellness Inc | Clinic/Center | 2128 6th Ave Se Ste 501, Decatur, AL 35601-6563 | 2019-09-09 |
| 1760035455 | Come As You Are Counseling and Consulting LLC | Clinic/Center | 2042 Beltline Rd Sw Ste A120, Decatur, AL 35601-5691 | 2019-07-22 |
| 1225502057 | Crossing Recovery Center | Clinic/Center | 495 E. Central Ave, Decatur, IL 62521-4665 | 2019-01-15 |
| 1013491109 | Dayspring Counseling, LLC | Clinic/Center | 255 Grant St Se Ste 303, Decatur, AL 35601-2505 | 2018-09-24 |
| 1841739059 | Dr. Emily Katz Psychological Services | Clinic/Center | 1201 Clairmont Rd Ste 100, Decatur, GA 30030-1258 | 2017-02-21 |
| 1871971127 | L.i.n.k. Family Services | Clinic/Center | 3115 Sandlin Rd Sw, Decatur, AL 35603-1387 | 2015-05-07 |
| 1356651582 | Brightpath Behavioral Health Group, L.L.C. | Clinic/Center | 2969 E Ponce De Leon Ave, Decatur, GA 30030-2215 | 2010-10-21 |
| 1043456908 | New Joshuas Circle of Hope for Mental Wellness & Recovery | Clinic/Center | 201 Thicket Way, Decatur, GA 30035-3700 | 2008-12-25 |
| 1275164741 | Webster Cantrell Youth Advocacy | Clinic/Center | 2749 N Norwood Ave, Decatur, IL 62526-1517 | 2020-02-03 |
| Find all providers in DECATUR | ||||
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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.