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15D2237195 CLIA NUMBER - PADDOCK VIEW RESIDENTIAL CENTER, INC

Laboratory Demographics

CLIA Number: 15D2237195

Facility Name: PADDOCK VIEW RESIDENTIAL CENTER, INC

Facility Address:
1700 EAST BRADFORD STREET
MARION, IN
ZIP 46952
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Facility Phone Number: 765 664-7740

Facility Type: Other - RESIDENTIAL TREATMENT PRO

Certificate Type: Waiver
NPI Number: 1396082863

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name Field Value
CLIA Number 15D2237195
LAB Type Other - RESIDENTIAL TREATMENT PRO
Facility Name PADDOCK VIEW RESIDENTIAL CENTER, INC
Street 1700 EAST BRADFORD STREET
City MARION
State IN
ZIP 46952
Phone 765 664-7740
CertificateType 4
CertificateEffectiveDate 9/23/2023
CertificateExpirationDate 9/22/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024