GRACE RECOVERY AND WELLNESS LLC
NPI 1881157329
Substance Abuse Rehabilitation Facility in Anderson, IN

Active since April 11, 2019CLIA 15D2292438 · Waiver
1400 BROADWAY ST, ANDERSON, IN 46012(888) 228-5485(765) 393-2563 Get Directions Write a Review

NPPES record last updated: February 24, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Feb 24, 2022, Apr 11, 2019 (2 updates tracked since 2019).

  • Organization
  • Substance Abuse Rehabilitation Facility
  • CLIA Number: 15D2292438
  • CLIA Cert. Type: Other - SUBSTANCE ABUSE TREATMENT
  • CLIA Exp. Date: 10-24-2027

About GRACE RECOVERY AND WELLNESS LLC

This page provides the complete NPI Profile along with additional information for Grace Recovery And Wellness Llc, a provider established in Anderson, Indiana operating as a Substance Abuse Rehabilitation Facility. The healthcare provider is registered in the NPI registry with number 1881157329 assigned on April 2019. The practitioner's primary taxonomy code is 324500000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Robert Slack (Director Of It)

NPI
1881157329 Verify this NPI
Provider Name
GRACE RECOVERY AND WELLNESS LLC
Entity Type
Organization
Location Address
1400 BROADWAY ST ANDERSON, IN 46012
Location Phone
(888) 228-5485
Location Fax
(765) 393-2563
Mailing Address
1400 BROADWAY ST ANDERSON, IN 46012
Mailing Phone
(888) 228-5485
Mailing Fax
(765) 393-2563
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-11-2019
Last Update Date
02-24-2022
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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

Substance Abuse Rehabilitation Facility

Taxonomy Code
324500000X
Type
Residential Treatment Facilities
Taxonomy Description
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ROBERT SLACK

Authorized Official Title
DIRECTOR OF IT
Authorized Official Phone
(888) 228-5485

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
15D2292438
Facility Type
Other - SUBSTANCE ABUSE TREATMENT
Certificate Effective Date
October 25, 2025
Certificate Expiration Date
October 24, 2027
Laboratory Director
KARL LAZAR
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Grace Recovery And Wellness 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.

Substance Abuse Rehabilitation Facility
1400 BROADWAY ST
ANDERSON, IN 46012

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1881157329, enumerated as an "organization" on April 11, 2019.

The provider is located at 1400 BROADWAY ST ANDERSON, IN 46012 and the phone number is (888) 228-5485.

Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.