Organization · Type 2 NPI
Jay-Randolph Developmental Services, Inc.
Intellectual Disabilities Intermediate Care Facility · Portland, IN
NPI number
1831143478
Active
Practice location
901 E Water St
Portland, IN 47371-2038
Fax (260) 726-8184
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 2623I0005JN06 (IN) |
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 2623I0004JN07 (IN) |
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 2623B0006JN06 (IN) |
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | 2623T0003JN07 (IN) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
About NPI 1831143478
Jay-Randolph Developmental Services, Inc.'s National Provider Identifier is 1831143478, issued on May 19, 2006. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Portland, IN. The record was last updated on Aug 22, 2020.