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PARK CENTER, INC.
NPI 1366719171
Clinic/Center - Mental Health (Including Community Mental Health Center) in Decatur, IN

Active since November 22, 2011CLIA 15D2140415 · Waiver
809 HIGH ST, DECATUR, IN 46733(260) 724-9669(260) 724-4872 Get Directions Write a Review

NPPES record last updated: October 31, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Park Center, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PARK CENTER, INC. (NPI 1366719171) is a healthcare organization registered as a mental health (including community mental health center) in Decatur, Indiana and active in the NPI registry since November 2011. The organization holds a CLIA Waiver certificate valid through November 20, 2027 and lists Stanton Risser, Acfo, as its authorized official.

NPPES Registry Identity

NPI1366719171
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NamePARK CENTER, INC.
Location Address809 HIGH STDecatur, IN 46733-2324
Mailing Address909 E State BlvdFort Wayne, IN 46805-3404 · (260) 481-2700 · Fax (260) 481-2709
Phone(260) 724-9669
Fax(260) 724-4872
Organization SubpartYes
Authorized OfficialStanton RisserAcfo · (260) 266-9380
Enumeration DateNovember 22, 2011
Last NPPES UpdateOctober 31, 2024
NPPES CertifiedOctober 31, 2024
✔ NPI 1366719171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
809 HIGH ST, Decatur, IN 46733
Open in Google Maps ↗

Other Identifiers 1

Medicaid201033910AIN

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2140415

Park Center, Inc Decatur Office · Decatur, IN
Active · expires Nov 20, 2027
CLIA Number15D2140415
Laboratory TypePhysician Office
Certificate Effective DateNovember 21, 2025
Certificate Expiration DateNovember 20, 2027
Laboratory DirectorAhsan Mahmood
Laboratory Phone(260) 724-9669
Laboratory LocationPark Center, Inc Decatur Office809 High Street, Decatur, IN 46733
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEIDI KRAUSE
Social Worker (Clinical)
809 HIGH ST
DECATUR, IN 46733
Adams County (260) 373-8379
AMY L SHAW
Case Manager/Care Coordinator
809 HIGH ST
DECATUR, IN 46733
Adams County (260) 724-9669
SABRA ANN VANAUKEN
Counselor (Mental Health)
809 HIGH ST
DECATUR, IN 46733
Adams County (260) 724-9669
KARLA A LIPSEY
Counselor (Mental Health)
809 HIGH ST
DECATUR, IN 46733
Adams County (260) 724-9669
JOSHUA A KAUFMANN
Case Manager/Care Coordinator
809 HIGH ST
DECATUR, IN 46733
Adams County (260) 724-9669
ROBERT MICHAEL CORRAL M. ED, CSAYC
Marriage & Family Therapist
809 HIGH ST
DECATUR, IN 46733
Adams County (260) 724-9669
KYRA ALEXANDRA WINKLER
Counselor (Mental Health)
809 HIGH ST
DECATUR, IN 46733
Adams County (260) 724-9669
MEGAN ELIZABETH MULLET
Counselor (Mental Health)
809 HIGH ST
DECATUR, IN 46733
Adams County (260) 724-9669

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Park Center, Inc.'s NPI number?

The NPI number for Park Center, Inc. is 1366719171. It was assigned to this organization in the NPPES registry on November 22, 2011.

Where is Park Center, Inc. located?

Park Center, Inc. is located at 809 High St, Decatur, IN 46733. The listed phone number is (260) 724-9669.

What is Park Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Does Park Center, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2140415) is associated with this NPI, valid through November 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Park Center, Inc. was last updated on October 31, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.