Healthcare Provider Details

I. General information

NPI: 1932994068
Provider Name (Legal Business Name): GRINNELL RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 6TH AVE W
GRINNELL IA
50112-8236
US

IV. Provider business mailing address

3960 SOUTHEASTERN AVE
INDIANAPOLIS IN
46203-1500
US

V. Phone/Fax

Practice location:
  • Phone: 317-947-0233
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MOSHE ORLNSKY
Title or Position: CEO
Credential:
Phone: 317-341-5141