Provider Demographics
NPI:1770970576
Name:ADAPTIVE COMMUNITY SUPPORT SERVICES INC
Entity type:Organization
Organization Name:ADAPTIVE COMMUNITY SUPPORT SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGEMENT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PELKINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-746-5391
Mailing Address - Street 1:3006 EASTPOINT PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4185
Mailing Address - Country:US
Mailing Address - Phone:502-795-0773
Mailing Address - Fax:800-990-2526
Practice Address - Street 1:3216 BALLARD LN
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-7200
Practice Address - Country:US
Practice Address - Phone:812-590-2157
Practice Address - Fax:800-990-2526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-20
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300007217Medicaid
IN300042650Medicaid
IN300076118Medicaid
IN300097057Medicaid
IN300075572Medicaid
KY7100721010Medicaid
IN300042413Medicaid
IN300063174Medicaid