SEQUEL TSI OF INDIANA, LLC (NPI# 1356671192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356671192 |
| Entity Type | Organization |
| Organization Name | SEQUEL TSI OF INDIANA, LLC |
| Other Organization Name | ENGLISHTON PARK |
| Practice Address |
2426 S Parker Ln Lexington IN 47138-8561 |
| Practice Telephone | 8128893992 |
| Practice Fax Number | 8128893990 |
| Mailing Telephone | 8128893992 |
| Mailing Fax Number | 8128893990 |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2009-12-29 |
| Authorized Official Name | MR. JOHN STUPAK (PRESIDENT) |
| Authorized Official Telephone | 2674198913 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Englishton Park | Doing Business As Name - Organization |
| Street Address |
2426 S PARKER LN |
| City | LEXINGTON |
| State | IN |
| Zip Code | 47138-8561 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770064966 | Elizabeth Webber | Developmental Therapist | 11888 W Polk Rd, Lexington, IN 47138-6843 | 2018-08-24 |
| 1073612073 | David William Lipke | Anesthesiology | 10558 W Polk Rd, Lexington, IN 47138-7013 | 2006-09-22 |
| 1285727578 | Donald Morris Bridges | Nurse Anesthetist, Certified Registered | 2344 S 1000, Lexington, IN 47138-7163 | 2006-10-02 |
| 1891279402 | Paula D. Stoner | Developmental Therapist | 8624 W State Road 356, Lexington, IN 47138-7616 | 2018-09-19 |
| 1023616125 | Kimberly Dawn Calloway | Nurse Practitioner | 5306 E Blocher Rd, Lexington, IN 47138-8803 | 2020-10-12 |
| 1326535675 | Alisa Rae Cox | Social Worker | 5135 E Polk Rd, Lexington, IN 47138-8863 | 2018-04-21 |
| 1811486723 | Ccc Therapy Center LLC | Social Worker | 5135 E Polk Rd, Lexington, IN 47138-8863 | 2018-05-07 |
| 1497314231 | Heather K. M. Crites | Nurse Practitioner | 422 N Napper Rd, Lexington, IN 47138-8880 | 2019-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861339 | Lexington Dental Group LLC | Dentist | 35 Bedford St Ste 110, Lexington, MA 02420-4320 | 2020-11-06 |
| 1780285742 | Ivan William Miller Jr. | Technician | 241 Silvercrest Dr, Lexington, OH 44904-9364 | 2020-11-05 |
| 1184225161 | Christina Chan Sok | Nurse Practitioner | 24 Hartwell Ave # 204, Lexington, MA 02421-3132 | 2020-11-05 |
| 1831790013 | Jennifer Waterman | Behavior Technician | 333 W Butler St, Lexington, SC 29072-2605 | 2020-11-04 |
| 1497356521 | Kimberly Meier | Audiologist | 1000 Falcon Wood Way, Lexington, KY 40511-9089 | 2020-11-04 |
| 1164023271 | Elizabeth Roth | Chiropractor | 3650 Boston Rd Ste 188, Lexington, KY 40514-1502 | 2020-11-04 |
| 1871194381 | Stacie Rose | Nurse Practitioner | 131 Hartwell Ave, Lexington, MA 02421-3105 | 2020-11-03 |
| 1063013571 | Andrew William Peters | Pharmacist | 301 Castor Rd Apt 104, Lexington, OH 44904-8745 | 2020-11-03 |
| 1770184368 | Shawn D Myers | Private Vehicle | 256 Otterbein Dr Apt E, Lexington, OH 44904-1053 | 2020-11-02 |
| 1841890431 | Alishia Gayle Euler | Family Medicine | 730 Della Dr, Lexington, KY 40504-3610 | 2020-11-01 |
| Find all providers in LEXINGTON | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487936449 | Florence Crittenton Home | Residential Treatment Facility, Emotionally Disturbed Children | 519 W Fourth St, Lexington, KY 40508-1205 | 2011-09-15 |
| 1174675623 | A Greater Divine Place Inc | Residential Treatment Facility, Emotionally Disturbed Children | 366 Bremen Garden Dr, Lexington, NC 27295-6044 | 2007-01-17 |
| 1760719553 | Pelham Academy | Residential Treatment Facility, Emotionally Disturbed Children | 13 Pelham Rd, Lexington, MA 02421-5707 | 2009-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417227984 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 2301 Jefferson St, Gary, IN 46407-3043 | 2011-12-30 |
| 1811206493 | Shults-lewis Child and Family Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 325 South 150 East, Valparaiso, IN 46383-7866 | 2010-09-30 |
| 1336454552 | Wernle Youth & Family Treatment Center | Residential Treatment Facility, Emotionally Disturbed Children | 2000 Wernle Rd, Richmond, IN 47374-7015 | 2010-08-12 |
| 1730494360 | Resource Community Based Services Inc | Residential Treatment Facility, Emotionally Disturbed Children | 1404 S State Ave, Indianapolis, IN 46203-2009 | 2010-08-06 |
| 1578897773 | Open Arms Christian Ministries, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4516 W State Road 54, Bloomfield, IN 47424-5207 | 2009-09-22 |
| 1871749119 | Gibault, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 6301 S Us Highway 41, Terre Haute, IN 47802-4771 | 2008-08-18 |
| 1528285897 | St. Joseph Home for Boys, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 4007 S Sheffield Ave, Hammond, IN 46327-1242 | 2007-04-19 |
| 1144353715 | Willowglen Academy - Indiana | Residential Treatment Facility, Emotionally Disturbed Children | 308 E 21st Ave, Gary, IN 46407-2618 | 2007-03-13 |
| 1861587230 | Success Acq Corp | Residential Treatment Facility, Emotionally Disturbed Children | 3455 West Vermont, Indianapolis, IN 46222 | 2006-10-03 |
| 1699868893 | Crossroad - Fort Wayne Childrens Home | Residential Treatment Facility, Emotionally Disturbed Children | 2525 Lake Ave, Fort Wayne, IN 46805-5407 | 2006-10-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.