East Indiana Treatment Center, Llc is a medicare enrolled primary clinic (Clinic/center - Methadone) in Greendale, Indiana. The current practice location for East Indiana Treatment Center, Llc is 816 Rudolph Way, Greendale, Indiana. For appointments, you can reach them via phone at
(812) 537-1668. The mailing address for East Indiana Treatment Center, Llc is 6185 Paseo Del Norte Ste 150, Carlsbad, California and phone number is (760) 710-0819.
East Indiana Treatment Center, Llc is licensed to practice in Indiana (license number 10780ASR). The clinic also participates in the medicare program and its
NPI number is 1013060714. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(812) 537-1668.
Primary Care Clinic Profile
| Full Name | East Indiana Treatment Center, Llc |
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| Speciality | Clinic/Center |
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| Location | 816 Rudolph Way, Greendale, Indiana |
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| Authorized Official Name and Position | Peter F Morris (PRESIDENT, CTC DIVISION) |
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| Authorized Official Contact | 6157211297 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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East Indiana Treatment Center, Llc
6185 Paseo Del Norte Ste 150
Carlsbad
CA 92011-1155
Ph: (760) 710-0819 | East Indiana Treatment Center, Llc
816 Rudolph Way
Greendale
IN 47025-8312
Ph: (812) 537-1668 |
NPI Details:
| NPI Number | 1013060714 |
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| Provider Enumeration Date | 01/18/2007 |
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| Last Update Date | 07/31/2018 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 0547694697 |
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| Medicare Enrollment ID | O20191223001739 |
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Medical Identifiers
Medical identifiers for East Indiana Treatment Center, Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013060714 | NPI | - | NPPES |
| 0279713 | Medicaid | OH | |
| 201345410A | Medicaid | IN | |
| 3000012052 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 261Q00000X | Clinic/center | 10780ASR (Indiana) | Secondary |
| 261QM2800X | Clinic/center - Methadone | 10780ASR (Indiana) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | 10780ASR (Indiana) | Secondary |
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