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NPI Code Detail

MEDICARE: REM INDIANA

MEDICARE: REM INDIANA
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
1315P00000XIntellectual Disabilities Intermediate Care Facility2524I0032JN08IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1100244980OTHERINPROVIDER NUMBER

General Provider Information

NPI Number : 1952434706
Entity Type Code : Organization
Provider Name (Legal Business Name) : REM INDIANA
Provider Business Mailing Address
First Line : 9000 KEYSTONE XING STE 200
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46240-2148
Country : US
Telephone Number : 317-581-2380
Fax Number : 317-581-2378
Provider Business Practice Location Address
First Line : 7085 ALLISONVILLE RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-3895
Country : US
Telephone Number : 317-251-7832
Fax Number :
Authorized Official
Title or Position : COO
Name : BRETT IAN COHEN
Credential :
Telephone Number : 800-388-5150
Provider Enumeration Date : 03/13/2007
Last Update Date : 04/19/2023

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Directions to “REM INDIANA ” Practice Location

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