MEDICARE: RTC RESOURCE ACQUISITION CORPORATION

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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	5103409833577	IN
2	323P00000X	Psychiatric Residential Treatment Facility

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	:	1245324755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RTC RESOURCE ACQUISITION CORPORATION

Provider Business Mailing Address
First Line	:	4020 ASPEN GROVE DR STE 900
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-3134
Country	:	US
Telephone Number	:	615-861-6000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1404 SOUTH STATE AVENUE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203
Country	:	US
Telephone Number	:	317-783-4003
Fax Number	:	317-783-4810

Authorized Official
Title or Position	:	VICE PRESIDENT AND SECRETARY
Name	:	BRIAN P FARLEY
Credential	:
Telephone Number	:	615-861-6000

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	01/20/2026

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Directions to “RTC RESOURCE ACQUISITION CORPORATION ” Practice Location

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