ICR OPERATING SUBSIDIARY, LLC
NPI 1629928767
Psychiatric Residential Treatment Facility in Bloomington, IN
- Organization
- Psychiatric Residential Treatment Facili...
- CLIA Number: 15D2141608
- CLIA Cert. Type: Other - SUBSTANCE ABUSE FACILITY
- CLIA Exp. Date: 12-17-2027
About ICR OPERATING SUBSIDIARY, LLC
This page provides the complete NPI Profile along with additional information for Icr Operating Subsidiary, 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 1629928767 assigned on January 2026. The practitioner's primary taxonomy code is 323P00000X. 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
- 1629928767
- Provider Name
- ICR OPERATING SUBSIDIARY, LLC
- Entity Type
- Organization
- Location Address
- 1004 W 1ST ST BLOOMINGTON, IN 47403
- Location Phone
- (812) 393-5596
- Mailing Address
- 2925 10TH AVE N PALM SPRINGS, FL 33461
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-29-2026
- Last Update Date
- 05-28-2026
- Code Navigator
Location Map
Secondary Locations
- 421 W 1st St
Bloomington, IN 47403
(812) 393-5596 - 1000 W 1st St
Bloomington, IN 47403
(812) 393-5596 - 637 S Walker St Ste 2
Bloomington, IN 47403
(812) 393-5596 - 909 W 1st St
Bloomington, IN 47403
(812) 393-5596
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) |
|---|---|---|---|---|
| 1 | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | |
| 2 | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| 3 | 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
- 15D2141608
- Facility Type
- Other - SUBSTANCE ABUSE 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 Icr 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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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 1629928767, we treat the final digit (7) 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 73. The final step is to find the difference between that total and the next multiple of ten (80 - 73 = 7).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 73 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
BLOOMINGTON, IN 47403
BLOOMINGTON, IN 47403
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629928767, enumerated as an "organization" on January 29, 2026.
The provider is located at 1004 W 1ST ST BLOOMINGTON, IN 47403 and the phone number is (812) 393-5596.
Psychiatric Residential Treatment Facility with taxonomy code 323P00000X.
