INDIANA CENTER FOR RECOVERY, LLC
NPI 1295276160
Psychiatric Residential Treatment Facility in Bloomington, IN
NPI Status: Active since March 13, 2017
Contact Information
1004 W 1ST STREET
BLOOMINGTON, IN
ZIP 47403
Phone: (561) 461-3791
Fax: (888) 516-3613
- Organization
- Psychiatric Residential Treatment Facili...
- CLIA Number: 15D2141608
- CLIA Cert. Type: Comp. Outpatient Rehab Facility
- CLIA Exp. Date: 12-17-2025
About INDIANA CENTER FOR RECOVERY, LLC
This page provides the complete NPI Profile along with additional information for Indiana Center For Recovery, Llc, a provider established in Bloomington, Indiana operating as a Psychiatric Residential Treatment Facility. The healthcare provider is registered in the NPI registry with number 1295276160 assigned on March 2017. The practitioner's primary taxonomy code is 323P00000X. The provider is registered as an organization and their NPI record was last updated April 2025. The authorized official of this NPI record is Mr. Kirill Vesselov (President)
- NPI
- 1295276160
- Provider Name
- INDIANA CENTER FOR RECOVERY, LLC
- Entity Type
- Organization
- Location Address
- 1004 W 1ST STREET BLOOMINGTON, IN 47403
- Location Phone
- (561) 461-3791
- Location Fax
- (888) 516-3613
- Mailing Address
- 1004 W 1ST STREET BLOOMINGTON, IN 47403
- Mailing Phone
- (561) 635-2400
- Mailing Fax
- (888) 516-3613
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-13-2017
- Last Update Date
- 04-30-2025
- Code Navigator
Location Map
Secondary Locations
- 1000 W 1st St
Bloomington, IN 47403
(812) 822-2510 - 909 W 1st St
Bloomington, IN 47403
(812) 822-2510 - 421 W 1st St
Bloomington, IN 47403
(561) 461-3791 - 637 S Walker St Ste 2
Bloomington, IN 47403
(561) 461-3791
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatric Residential Treatment Facility
- Taxonomy Code
- 323P00000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| 3 | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | 1759-0ASO (IN) |
| 4 | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D2141608
- Facility Type
- Comp. Outpatient Rehab Facility
- Certificate Effective Date
- December 18, 2023
- Certificate Expiration Date
- December 17, 2025
- Laboratory Director
- MICHAEL KANE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Indiana Center For Recovery, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for INDIANA CENTER FOR RECOVERY, LLC
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 9 | 5 | 2 | 7 | 6 | 1 | 6 | 0 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 18 | 5 | 4 | 7 | 12 | 1 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 8 + 5 + 4 + 7 + 1 + 2 + 1 + 1 + 2 + 24 = 60 | |||||||||
| Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
| 0 | |||||||||
The NPI number 1295276160 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295276160, enumerated in the NPI registry as an "organization" on March 13, 2017
The provider is located at 1004 W 1st Street Bloomington, In 47403 and the phone number is (561) 461-3791
This medical organization specializes in Psychiatric Residential Treatment Facility with taxonomy code 323P00000X
The provider's CLIA number is 15D2141608 for a "comp. outpatient rehab facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on March 13, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.