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Icr Operating Subsidiary, LLC — NPI 1629928767, Bloomington, IN | NPI Central

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NPI 1629928767

OrganizationActive

Icr Operating Subsidiary, LLC

NPI 1629928767 · Psychiatric Residential Treatment Facility · Bloomington, IN

Provider details

NPI number: 1629928767
Entity type: Organization
Primary specialty: Psychiatric Residential Treatment FacilityResidential Treatment Facilities
Organization subpart: No
Authorized official: Tara Gurney, Authorized Official(561) 517-3400

Specialties & taxonomies

Psychiatric Residential Treatment FacilityPrimary323P00000X
Residential Treatment Facilities
Substance Abuse Rehabilitation Facility324500000X
Residential Treatment Facilities
Mental Illness Community Based Residential Treatment Facility320800000X
Residential Treatment Facilities
Substance Use Disorder Rehabilitation Clinic/Center261QR0405X
Ambulatory Health Care Facilities

Practice location

1004 W 1st St

Bloomington, IN 47403-2208

Phone: (812) 393-5596

Approximate (ZIP-level) locationGet directions

More IN providers

Mailing address

2925 10th Ave N

Palm Springs, FL 33461-3000

Additional practice locations (4)

637 S Walker St Ste 2
Bloomington, IN 47403-2175
Phone: (812) 393-5596
909 W 1st St
Bloomington, IN 47403-2274
Phone: (812) 393-5596
421 W 1st St
Bloomington, IN 47403-2403
Phone: (812) 393-5596
1000 W 1st St
Bloomington, IN 47403-2208
Phone: (812) 393-5596

Registry dates

Enumerated: 2026-01-29
Last updated: 2026-05-28
Certified: 2026-05-28

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.