Healthcare Provider Details

I. General information

NPI: 1780354522
Provider Name (Legal Business Name): SEYMOUR TREATMENT CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

357 TANGER BLVD STE:215
SEYMOUR IN
47274-1800
US

IV. Provider business mailing address

PO BOX 682669
FRANKLIN TN
37068-2669
US

V. Phone/Fax

Practice location:
  • Phone: 812-558-9016
  • Fax: 812-522-0291
Mailing address:
  • Phone: 760-710-0819
  • Fax: 877-552-0439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIAN PHILLIP FARLEY
Title or Position: VP & SECRETARY
Credential:
Phone: 615-716-9335