PARK CENTER INC. NPI 1366719171

NPI Information

NPI: 1366719171
Provider Name: PARK CENTER, INC.
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

CLIA Number: 15D2140415

Address:
809 HIGH ST
DECATUR, IN
ZIP 46733
Phone: (260) 724-9669
Get Directions

PARK CENTER, INC. is a mental health (including community mental health center) clinic center in Decatur, IN. PARK CENTER, INC. NPI is 1366719171. The provider is registered as an organization entity type.

The provider's business location address is:

809 HIGH ST
DECATUR, IN
ZIP 46733-324
Phone: (260) 724-9669
Fax: (260) 724-4872

The provider's authorized official is Paul Wilson .
The authorized official title is President & Ceo and has the following contact phone number (260) 481-2700.

The CLIA number assigned to this NPI record is 15D2140415 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/22/2011 and was last updated on 11/22/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	945300	MEDICARE UPIN
2	201033910A	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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