ADEC - STEVENS AVE
NPI 1235353608
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Elkhart, IN
- Organization
- Residential Treatment Facility, Intellec...
- CLIA Number: 15D0886821
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 05-26-2026
About ADEC - STEVENS AVE
This page provides the complete NPI Profile along with additional information for Adec - Stevens Ave, a provider established in Elkhart, Indiana operating as a Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1235353608 assigned on April 2007. The practitioner's primary taxonomy code is 320600000X with license number 2670I0015DE08 (IN). The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Paula M Shively (Ceo)
- NPI
- 1235353608 Verify this NPI
- Provider Name
- ADEC - STEVENS AVE
- Entity Type
- Organization
- Location Address
- 2001 STEVENS AVE ELKHART, IN 46516
- Location Phone
- (574) 848-7451
- Location Fax
- (574) 848-5917
- Mailing Address
- 19670 SR 120 BRISTOL, IN 46507
- Mailing Phone
- (574) 848-7451
- Mailing Fax
- (574) 848-5917
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-13-2007
- Last Update Date
- 08-22-2020
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Location Map
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
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Taxonomy Code
- 320600000X
- Type
- Residential Treatment Facilities
- License No.
- 2670I0015DE08
- License State
- IN
- Taxonomy Description
- A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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
- 15D0886821
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- May 27, 2024
- Certificate Expiration Date
- May 26, 2026
- Laboratory Director
- CHRISTOPHER J. KINGSLEY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Adec - Stevens Ave 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.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235353608, enumerated as an "organization" on April 13, 2007.
The provider is located at 2001 STEVENS AVE ELKHART, IN 46516 and the phone number is (574) 848-7451.
Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.
