Healthcare Provider Details
I. General information
NPI: 1003969767
Provider Name (Legal Business Name): RICHMOND TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2007
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4265 S A ST
RICHMOND IN
47374-6049
US
IV. Provider business mailing address
PO BOX 682669
FRANKLIN TN
37068-2669
US
V. Phone/Fax
- Phone: 765-962-8843
- Fax: 765-965-4564
- Phone: 760-710-0819
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2800X |
| Taxonomy | Methadone Clinic |
| License Number | 1382-0-ASR |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | 1382-0-ASR |
| License Number State | IN |
VIII. Authorized Official
Name:
BRIAN
PHILLIP
FARLEY
Title or Position: VP & SECRETARY
Credential:
Phone: 615-861-6000