JAY-RANDOLPH DEVELOPMENTAL SERVICES, INC.
NPI 1831143478
Intermediate Care Facility, Intellectual Disabilities in Portland, IN

Q: What is Jay-Randolph Developmental Services, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Active since May 19, 2006CLIA 15D0997488 · Waiver

901 E WATER ST, PORTLAND, IN 47371(260) 726-7931(260) 726-8184 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Jay-randolph Developmental Services, Inc. NPPES

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

JAY-RANDOLPH DEVELOPMENTAL SERVICES, INC. (NPI 1831143478) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Portland, Indiana and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through March 18, 2028 and lists Anita Young, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1831143478

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameJAY-RANDOLPH DEVELOPMENTAL SERVICES, INC.

Location Address901 E WATER STPortland, IN 47371-2038

Mailing Address901 E Water StPortland, IN 47371-2038 · (260) 726-7931 · Fax (260) 726-8184

Phone(260) 726-7931

Fax(260) 726-8184

Organization SubpartNo

Authorized OfficialAnita YoungExecutive Director · (260) 726-7931

Enumeration DateMay 19, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1831143478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities

Taxonomy Code315P00000X

Licenses✔ Licensed in IN · 2623I0005JN06✔ Licensed in IN · 2623I0004JN07✔ Licensed in IN · 2623B0006JN06✔ Licensed in IN · 2623T0003JN07

Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

901 E WATER ST, Portland, IN 47371

Open in Google Maps ↗

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 15D0997488

Jay Randolph Developmental Services · Portland, IN

Active · expires Mar 18, 2028

CLIA Number15D0997488

Laboratory TypeIntermediate Care Facility For Mentally Retarded

Certificate Effective DateMarch 19, 2026

Certificate Expiration DateMarch 18, 2028

Laboratory DirectorJames M. Sinclair

Laboratory Phone(260) 726-7931

Laboratory LocationJay Randolph Developmental Services522 E North St, Portland, IN 47371

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Jay-Randolph Developmental Services, Inc.'s NPI number?

The NPI number for Jay-Randolph Developmental Services, Inc. is 1831143478. It was assigned to this organization in the NPPES registry on May 19, 2006.

Where is Jay-Randolph Developmental Services, Inc. located?

Jay-Randolph Developmental Services, Inc. is located at 901 E Water St, Portland, IN 47371. The listed phone number is (260) 726-7931.

What is Jay-Randolph Developmental Services, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Jay-Randolph Developmental Services, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D0997488) is associated with this NPI, valid through March 18, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jay-Randolph Developmental Services, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.