GIBAULT , INC. (NPI# 1871749119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871749119 |
| Entity Type | Organization |
| Organization Name | GIBAULT , INC. |
| Other Organization Name | GIBAULT CHILDREN'S SERVICES |
| Practice Address |
6301 S Us Highway 41 Terre Haute IN 47802-4771 |
| Mailing Address |
6301 S Us Highway 41 Po Box 2316 Terre Haute IN 47802-4771 |
| Practice Telephone | 8122991156 |
| Practice Fax Number | 8122983044 |
| Mailing Telephone | 8122991156 |
| Mailing Fax Number | 8122983044 |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |
| Authorized Official Name | JAMES M SINCLAIR (PRESIDENT/CEO) |
| Authorized Official Telephone | 8122983002 |
| Authorized Official Credential | MSSW, JD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 32301 | IN | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 45049194 | 05 |
| Other Name | Type Code |
|---|---|
| Gibault Children's Services | Doing Business As Name - Organization |
| Street Address |
6301 S US HIGHWAY 41 |
| City | TERRE HAUTE |
| State | IN |
| Zip Code | 47802-4771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184242364 | Sowjanya Gunukula | Dentist | 3359 S Us Hwy 41, Terre Haute, IN 47802 | 2020-07-14 |
| 1366005027 | Irma D Davis Lmft | Marriage & Family Therapist | 1400 South Pugh Drive, Suite #3, Terre Haute, IN 47802 | 2019-04-18 |
| 1255892543 | Darcie Jo Antony | Dietitian, Registered | 3901 South 7th St, Dietitian's Office 4th Floor, Terre Haute, IN 47802 | 2019-03-28 |
| 1548726003 | James Brian Levenson | Nurse Practitioner | 670 Margaret Dr, Terre Haute, IN 47802 | 2019-02-20 |
| 1972011815 | Wellness for Life Medical LLC | Clinic/Center | 3487 S 4th St, Terre Haute, IN 47802 | 2018-01-12 |
| 1992211965 | Megan Elizabeth Marietta | Nurse Practitioner | 3487 S 4th Street, Terre Haute, IN 47802 | 2017-12-28 |
| 1396187944 | Marc Keilman | Pharmacist | 1240 E Hook Dr, Terre Haute, IN 47802 | 2013-07-24 |
| 1043563364 | Indiana Hearing LLC | Hearing Aid Equipment | 3181 S 3rd Pl, Terre Haute, IN 47802 | 2012-10-24 |
| 1619241783 | Michael James Elkins Shanks | Urology | 3401 S 4th St, Terre Haute, IN 47802 | 2012-03-06 |
| 1073890208 | Christopher Allan Blila | Nurse Practitioner | 4700 Bureau Road South, Terre Haute, IN 47802 | 2011-11-16 |
| Find all providers in zip 47802 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417227984 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 2301 Jefferson St, Gary, IN 46407-3043 | 2011-12-30 |
| 1811206493 | Shults-lewis Child and Family Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 325 South 150 East, Valparaiso, IN 46383-7866 | 2010-09-30 |
| 1336454552 | Wernle Youth & Family Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 2000 Wernle Rd, Richmond, IN 47374-7015 | 2010-08-12 |
| 1730494360 | Resource Community Based Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1404 S State Ave, Indianapolis, IN 46203-2009 | 2010-08-06 |
| 1356671192 | Sequel Tsi of Indiana, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2426 S Parker Ln, Lexington, IN 47138-8561 | 2009-12-29 |
| 1578897773 | Open Arms Christian Ministries, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4516 W State Road 54, Bloomfield, IN 47424-5207 | 2009-09-22 |
| 1528285897 | St. Joseph Home for Boys, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4007 S Sheffield Ave, Hammond, IN 46327-1242 | 2007-04-19 |
| 1144353715 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-03-13 |
| 1861587230 | Success Acq Corp | Residential Treatment Facility, Emotionally Disturbed Children | 3455 West Vermont, Indianapolis, IN 46222 | 2006-10-03 |
| 1699868893 | Crossroad - Fort Wayne Childrens Home | Residential Treatment Facility, Emotionally Disturbed Children | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2006-10-02 |
| Find all providers with the same taxonomy | ||||
| City | TERRE HAUTE |
| Zip Code | 47802 |
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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.