ICR OPERATING SUBSIDIARY, LLC
NPI 1629928767
Psychiatric Residential Treatment Facility in Bloomington, IN

Active since January 29, 2026CLIA 15D2141608 · Waiver
1004 W 1ST ST, BLOOMINGTON, IN 47403(812) 393-5596 Get Directions Write a Review

NPPES record last updated: May 28, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 28, 2026, Mar 25, 2026, Jan 29, 2026 (3 updates tracked since 2026).

About Icr Operating Subsidiary, Llc NPPES

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

ICR OPERATING SUBSIDIARY, LLC (NPI 1629928767) is a healthcare organization registered as a psychiatric residential treatment facility in Bloomington, Indiana and active in the NPI registry since January 2026. The organization holds a CLIA Waiver certificate valid through December 17, 2027, maintains 4 additional practice locations, and lists Tara Gurney, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1629928767
Entity TypeOrganization
Primary Taxonomy323P00000X
Legal Business NameICR OPERATING SUBSIDIARY, LLC
Location Address1004 W 1ST STBloomington, IN 47403-2208
Mailing Address2925 10th Ave NPalm Springs, FL 33461-3000
Organization SubpartNo
Authorized OfficialTara GurneyAuthorized Official · (561) 517-3400
Enumeration DateJanuary 29, 2026
Last NPPES UpdateMay 28, 20263 updates tracked since enumeration
NPPES CertifiedMay 28, 2026
NPI 1629928767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPsychiatric Residential Treatment FacilityResidential Treatment Facilities
Taxonomy Code323P00000X
Definition
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
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X
1004 W 1ST ST, Bloomington, IN 47403

Secondary Practice Locations 4

Location 1909 W 1st StBloomington, IN 47403-2274 · Phone (812) 393-5596
Location 2637 S Walker St Ste 2Bloomington, IN 47403-2175 · Phone (812) 393-5596
Location 31000 W 1st StBloomington, IN 47403-2208 · Phone (812) 393-5596
Location 4421 W 1st StBloomington, IN 47403-2403 · Phone (812) 393-5596

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 15D2141608

Icr Operating Subsidiary, LLC · Bloomington, IN
Active · expires Dec 17, 2027
CLIA Number15D2141608
Laboratory TypeSubstance Abuse Facility
Certificate Effective DateDecember 18, 2025
Certificate Expiration DateDecember 17, 2027
Laboratory DirectorMichael Kane
Laboratory Phone(561) 307-1212
Laboratory LocationIcr Operating Subsidiary, LLC1004 W 1st Street, Bloomington, IN 47403
CLIA data matches this NPI record on: Address Name
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.

Social Worker (Clinical)
1004 W 1ST ST
BLOOMINGTON, IN 47403
Social Worker
1004 W 1ST ST
BLOOMINGTON, IN 47403
Social Worker (Clinical)
1004 W 1ST ST
BLOOMINGTON, IN 47403
Nurse Practitioner (Psychiatric/Mental Health)
1004 W 1ST ST
BLOOMINGTON, IN 47403
Social Worker (Clinical)
1004 W 1ST ST
BLOOMINGTON, IN 47403
Psychiatry & Neurology (Psychiatry)
1004 W 1ST ST
BLOOMINGTON, IN 47403
Nurse Practitioner (Psychiatric/Mental Health)
1004 W 1ST ST
BLOOMINGTON, IN 47403
Nurse Practitioner (Family)
1004 W 1ST ST
BLOOMINGTON, IN 47403

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 Icr Operating Subsidiary, LLC's NPI number?

The NPI number for Icr Operating Subsidiary, LLC is 1629928767. It was assigned to this organization in the NPPES registry on January 29, 2026.

Where is Icr Operating Subsidiary, LLC located?

Icr Operating Subsidiary, LLC is located at 1004 W 1st St, Bloomington, IN 47403. The listed phone number is (812) 393-5596.

What is Icr Operating Subsidiary, LLC's specialty?

The primary specialty registered for this NPI is Psychiatric Residential Treatment Facility with taxonomy code 323P00000X.

Does Icr Operating Subsidiary, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2141608) is associated with this NPI, valid through December 17, 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 Icr Operating Subsidiary, LLC was last updated on May 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.