SPA, INC. (NPI# 1417428400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417428400 |
| Entity Type | Organization |
| Organization Name | SPA, INC. |
| Practice Address |
23221 Old Us 20 Elkhart IN 46516-9772 |
| Mailing Address |
23221 Old Us 20 East Elkhart IN 46516-9772 |
| Practice Telephone | 5745228338 |
| Practice Fax Number | 5747426118 |
| Mailing Telephone | 5745228338 |
| Mailing Fax Number | 5747426118 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |
| Authorized Official Name | MRS. CARRIE ZICKEFOOSE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5745228338 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| SPA Women's Ministry Homes | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043332612 | Spa, Inc. | Speech-Language Pathologist | 3423 E Highland Dr Ste A, Jonesboro, AR 72401-6404 | 2007-04-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | SPA, INC. | 2465 Black Rock Tpke, Fairfield, CT 06825 |
| Street Address |
23221 OLD US 20 |
| City | ELKHART |
| State | IN |
| Zip Code | 46516-9772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558974675 | Courtney Rae Lawson | Nurse Practitioner | 1178 Fremont Ct., Elkhart, IN 46516 | 2020-08-28 |
| 1932690955 | Lisa Cooper | Counselor | 529 S 2nd St, Elkhart, IN 46516 | 2018-05-24 |
| 1780183558 | Evolve Chiropractic, LLC | Chiropractor | 5301 Beck Dr. Suite 3, Elkhart, IN 46516 | 2018-02-07 |
| 1790215168 | Cutting Edge Integrative Pain Centers LLC | Internal Medicine | 242 Waterfall Dr Ste B, Elkhart, IN 46516 | 2017-06-18 |
| 1831448745 | Planned Parenthood of Indiana Elkhart | Clinic/Center | 505 S. Third St., Suite 160, Elkhart, IN 46516 | 2012-09-06 |
| 1588920128 | Physical Therapy Professionals PC | Clinic/Center | 932 Parkway Ave, Ste. B, Elkhart, IN 46516 | 2012-04-09 |
| 1821369091 | Marek Serwatka | Physical Therapist | 932 Parkway Ave Ste B, Elkhart, IN 46516 | 2012-01-19 |
| 1538459904 | Rose M. Mwania | Nurse Anesthetist, Certified Registered | 1004 Parkway Ave Ste A, Elkhart, IN 46516 | 2011-04-19 |
| 1487894838 | Jack Alan Turnock | Dentist | 330 West Lexington Ave, Suite 201, Elkhart, IN 46516 | 2009-02-25 |
| 1225207285 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 30830 Old Us 33, Elkhart, IN 46516 | 2008-02-25 |
| Find all providers in zip 46516 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
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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.