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PARKDALE CENTER LLC NPI 1568834992


NPI Information

NPI: 1568834992
Provider Name: PARKDALE CENTER LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization

CLIA Number: 15D2103913

Address:
350 INDIAN BOUNDARY RD
CHESTERTON, IN
ZIP 46304
Phone: (888) 883-8433
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PARKDALE CENTER LLC is a substance abuse rehabilitation facility in Chesterton, IN. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. PARKDALE CENTER LLC NPI is 1568834992. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

350 INDIAN BOUNDARY RD
CHESTERTON, IN
ZIP 46304-511
Phone: (888) 883-8433

The provider's authorized official is Rodrigo Garcia .
The authorized official title is Owner and has the following contact phone number (219) 743-2477.

The CLIA number assigned to this NPI record is 15D2103913 - other - php -iop with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2015 and was last updated on 4/26/2023.


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
1101YA0400XCounselorAddiction (Substance Use Disorder)No
2101YM0800XCounselorMental HealthNo
3163WP0808XRegistered NursePsychiatric/Mental HealthNo
4261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
5363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
6324500000XSubstance Abuse Rehabilitation FacilityYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.