STONE BELT ARC INC. NPI 1134297591

NPI Information

NPI: 1134297591
Provider Name: STONE BELT ARC, INC.
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 15D0999167

Address:
1006 W 11TH ST
BLOOMINGTON, IN
ZIP 47404
Phone: (812) 337-0802
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STONE BELT ARC, INC. is an intermediate care facility mentally retarded in Bloomington, IN. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. STONE BELT ARC, INC. NPI is 1134297591. The provider is registered as an organization entity type.

The provider's business location address is:

1006 W 11TH ST
BLOOMINGTON, IN
ZIP 47404-237
Phone: (812) 337-0802

The provider's authorized official is Leslie Green .
The authorized official title is Ceo and has the following contact phone number (812) 332-2168.

The CLIA number assigned to this NPI record is 15D0999167 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/1/2006 and was last updated on 12/20/2013.

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	315P00000X	Intermediate Care Facility, Intellectual Disabilities		00001221BDE06	INDIANA	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	100240220	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: 4/28/2024

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