ICR OUTPATIENT OPERATING SUBSIDIARY, LLC
NPI 1568311900
Community Based Residential Treatment Facility, Mental Illness in Terre Haute, IN
- Organization
- Community Based Residential Treatment Fa...
- CLIA Number: 15D2288476
- CLIA Cert. Type: Other - SUBSTANCE ABUSE FACILITY
- CLIA Exp. Date: 08-24-2027
About ICR OUTPATIENT OPERATING SUBSIDIARY, LLC
This page provides the complete NPI Profile along with additional information for Icr Outpatient Operating Subsidiary, Llc, a provider established in Terre Haute, Indiana operating as a Community Based Residential Treatment Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1568311900 assigned on January 2026. The practitioner's primary taxonomy code is 320800000X. The provider is registered as an organization and their NPI record was last updated May 2026. The authorized official of this NPI record is Tara Gurney (Authorized Official)
- NPI
- 1568311900 Verify this NPI
- Provider Name
- ICR OUTPATIENT OPERATING SUBSIDIARY, LLC
- Entity Type
- Organization
- Location Address
- 135 HOSPITAL LN TERRE HAUTE, IN 47802
- Location Phone
- (812) 645-3895
- Mailing Address
- 2925 10TH AVE N PALM SPRINGS, FL 33461
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-27-2026
- Last Update Date
- 05-28-2026
- Code Navigator
Location Map
Secondary Locations
- 14555 Hazel Dell Pkwy
Carmel, IN 46033
(812) 645-3895 - 2529 Schuyler Ave Ste 700
Lafayette, IN 47905
(812) 645-3895 - 601 N Shore Dr
Jeffersonville, IN 47130
(812) 645-3895 - 7900 W Jefferson Blvd Ste 300
Fort Wayne, IN 46804
(812) 645-3895 - 1578 E 85th Ave
Merrillville, IN 46410
(812) 645-3895
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
Community Based Residential Treatment Facility, Mental Illness
- Taxonomy Code
- 320800000X
- Type
- Residential Treatment Facilities
- Taxonomy Description
- A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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) |
|---|---|---|---|---|
| 1 | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
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
- 15D2288476
- Facility Type
- Other - SUBSTANCE ABUSE FACILITY
- Certificate Effective Date
- August 25, 2025
- Certificate Expiration Date
- August 24, 2027
- Laboratory Director
- MICHAEL KANE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Icr Outpatient Operating Subsidiary, 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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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
TERRE HAUTE, IN 47802
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568311900, enumerated as an "organization" on January 27, 2026.
The provider is located at 135 HOSPITAL LN TERRE HAUTE, IN 47802 and the phone number is (812) 645-3895.
Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
