MEDICARE: REM OCCAZIO, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	2508B0013JN08	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730277898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REM OCCAZIO, INC.

Provider Business Mailing Address
First Line	:	9000 KEYSTONE XING STE 200
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46240-2148
Country	:	US
Telephone Number	:	800-388-5150
Fax Number	:	617-790-4271

Provider Business Practice Location Address
First Line	:	4312 W HUMMINGBIRD WAY
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47304-2803
Country	:	US
Telephone Number	:	765-521-0320
Fax Number	:	765-521-4454

Authorized Official
Title or Position	:	COO
Name	:	BRETT IAN COHEN
Credential	:
Telephone Number	:	800-388-5150

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	05/13/2023

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Directions to “REM OCCAZIO, INC. ” Practice Location

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