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

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  • Organization
  • Psychiatric Residential Treatment Facili...
  • CLIA Number: 15D2141608
  • CLIA Cert. Type: Comp. Outpatient Rehab Facility
  • CLIA Exp. Date: 12-17-2027

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 one year ago. 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
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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)
1261QR0405XAmbulatory Health Care Facilities

Clinic/Center
Rehabilitation, Substance Use Disorder

 
2320800000XResidential Treatment Facilities

Community Based Residential Treatment Facility, Mental Illness

 
3324500000XResidential Treatment Facilities

Substance Abuse Rehabilitation Facility

1759-0ASO (IN)
4324500000XResidential Treatment Facilities

Substance Abuse Rehabilitation Facility

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. KIRILL VESSELOV

Authorized Official Title
PRESIDENT
Authorized Official Phone
(561) 461-3791

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, 2025
Certificate Expiration Date
December 17, 2027
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.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1295276160, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
5
Unchanged
Pos 5
2
Doubled → 4
Pos 6
7
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
1
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 2 → 4 6 → 12 → 3 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 1 + 8 + 5 + 4 + 7 + 1 + 2 + 1 + 1 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1295276160.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295276160, enumerated 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.

Psychiatric Residential Treatment Facility with taxonomy code 323P00000X.