NORTHEASTERN CENTER (NPI# 1770646226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770646226 |
| Entity Type | Organization |
| Organization Name | NORTHEASTERN CENTER |
| Practice Address |
220 S Main St Kendallville IN 46755-1718 |
| Mailing Address |
Po Box 817 Kendallville IN 46755-0817 |
| Practice Telephone | 2603472453 |
| Practice Fax Number | 2603472456 |
| Mailing Telephone | 2603472453 |
| Mailing Fax Number | 2603472456 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JERRY HOLLISTER (CEO) |
| Authorized Official Telephone | 2603472453 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 426-0-CMHC | IN | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740326669 | Northeastern Center | Non-emergency Medical Transport (VAN) | 220 S Main St, Kendallville, IN 46755-1718 | 2007-01-29 |
| 1679636294 | Northeastern Center | Community/Behavioral Health | 220 S Main St, Kendallville, IN 46755-1718 | 2006-12-18 |
| 1174685358 | Northeastern Center | Community/Behavioral Health | 220 S Main St, Kendallville, IN 46755-1718 | 2006-12-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | NORTHEASTERN CENTER FOR FOREST GARDEN RESEARCH AND EDUCATION LTD. | 363 Blue Factory Road, Averill Park, Ny 12018 |
| Indiana Business Entities | NORTHEASTERN CENTER INC | 220 S Main, Kendallville, IN 46755 |
| Street Address |
220 S MAIN ST |
| City | KENDALLVILLE |
| State | IN |
| Zip Code | 46755-1718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467910125 | Nancy Luna | Case Manager/Care Coordinator | 220 S Main St, Kendallville, IN 46755-1718 | 2019-03-12 |
| 1558829143 | Leah M Watson | Case Manager/Care Coordinator | 220 S Main St, Kendallville, IN 46755-1718 | 2019-03-04 |
| 1760950869 | Molly Laisure | Case Manager/Care Coordinator | 220 S Main St, Kendallville, IN 46755-1718 | 2018-11-06 |
| 1497222533 | Travis L Smith | Case Manager/Care Coordinator | 220 S Main St, Kendallville, IN 46755-1718 | 2018-10-26 |
| 1467929505 | Cassandra Layne Mason | Case Manager/Care Coordinator | 220 S Main St, Kendallville, IN 46755-1718 | 2018-10-26 |
| 1609361062 | Pamela Thornton | Nurse Practitioner | 220 S Main St, Kendallville, IN 46755-1718 | 2018-06-28 |
| 1851609804 | Richard A Yost | Counselor | 220 S Main St, Kendallville, IN 46755-1718 | 2010-09-23 |
| 1962673111 | Dianne Elizabeth Daugherty | Social Worker | 220 S Main St, Kendallville, IN 46755-1718 | 2008-03-17 |
| 1992834311 | Halbert Bayless Miller | Psychiatry & Neurology | 220 S Main St, Kendallville, IN 46755-1718 | 2007-03-02 |
| 1740326669 | Northeastern Center | Non-emergency Medical Transport (VAN) | 220 S Main St, Kendallville, IN 46755-1718 | 2007-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700292422 | Dawn Levin | Physical Therapist | 1292 Drake Rd, Parkview Noble Therapy, Kendallville, IN 46755 | 2014-07-02 |
| 1679989495 | Elaine Patterson | Physical Therapist | 1292 Drake Rd., Parkview Noble Therapy, Kendallville, IN 46755 | 2014-07-02 |
| 1841606563 | Justin Todd Chaple | Physical Therapist | 1292 Drake Road, Parkview Noble Therapy, Kendallville, IN 46755 | 2014-07-02 |
| 1073802997 | Bryan William Smith | Counselor | 1930 Dowling St., Kendallville, IN 46755 | 2011-03-31 |
| 1417101247 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 124 E North St, Kendallville, IN 46755 | 2008-11-06 |
| 1770778367 | Assisted Living Concepts Inc | Assisted Living Facility | 2870 South Lima Road, Kendalville, IN 46755 | 2007-09-07 |
| 1629143805 | Kendallville Chiropractic Center Inc | Chiropractor | 1229 N Lima Rd, Kendallville, IN 46755 | 2006-11-22 |
| 1841307139 | Theodore L Deal Jr. | Dentist | 225 Fairview Blvd, Kendallville, IN 46755 | 2006-08-24 |
| 1467469858 | David Lee Holliday | Chiropractor | 930 West North St., Kendallville, IN 46755 | 2006-08-01 |
| 1699708370 | Vincent J Coda | Podiatrist | 410 E Mitchell St, Kendallville, IN 46755 | 2006-07-08 |
| Find all providers in zip 46755 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851744734 | Northeastern Center Inc | Community/Behavioral Health | 304 S Lincoln St, Kendallville, IN 46755-1675 | 2016-07-15 |
| 1679636294 | Northeastern Center | Community/Behavioral Health | 220 S Main St, Kendallville, IN 46755-1718 | 2006-12-18 |
| 1174685358 | Northeastern Center | Community/Behavioral Health | 220 S Main St, Kendallville, IN 46755-1718 | 2006-12-14 |
| 1720140908 | Northeastern Center Inc | Community/Behavioral Health | 220 S Main St, Kendallville, IN 46755-1718 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609473529 | Susan M Baker, Lcsw Inc | Community/Behavioral Health | 404 Washington St Ste 201-2, Columbus, IN 47201-6791 | 2020-10-04 |
| 1710599154 | We Are The Village Inc. | Community/Behavioral Health | 623 Washington St, Gary, IN 46402-2401 | 2020-08-18 |
| 1750993218 | Minds Matter, LLC | Community/Behavioral Health | 2205 E Morgan Ave Ste 122, Evansville, IN 47711-4358 | 2020-08-17 |
| 1629695739 | Connieflower Behavioral Health | Community/Behavioral Health | 6738 Tramcus Dr, Indianapolis, IN 46260-4586 | 2020-07-06 |
| 1437773322 | Carter Counseling Services LLC | Community/Behavioral Health | 1387 N Shadeland Ave Ste B, Indianapolis, IN 46219-3605 | 2020-06-05 |
| 1568084416 | Renaissance Counseling Center,llc | Community/Behavioral Health | 1210 Guthrie St, Fort Wayne, IN 46802 | 2020-05-14 |
| 1013538081 | Progressions Counseling, LLC | Community/Behavioral Health | 250 S Washington St Ste 2, Hobart, IN 46342-4151 | 2020-05-01 |
| 1265061998 | Gateway Psychological Services | Community/Behavioral Health | 435 E Main St Ste 195, Greenwood, IN 46143-1456 | 2020-04-04 |
| 1619500626 | Family Strength Services | Community/Behavioral Health | 10026 E 21st St Ste 9, Indianapolis, IN 46229-1802 | 2020-02-18 |
| 1619509080 | Revive Counseling and Wellness | Community/Behavioral Health | 317 S Eddy St, South Bend, IN 46617-3201 | 2020-02-04 |
| Find all providers with the same taxonomy | ||||
| City | KENDALLVILLE |
| Zip Code | 46755 |
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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.