Provider Demographics
NPI:1164939062
Name:UNITY HEALTHCARE LLC
Entity type:Organization
Organization Name:UNITY HEALTHCARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-446-5417
Mailing Address - Street 1:PO BOX 4699
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47903-4699
Mailing Address - Country:US
Mailing Address - Phone:765-446-5417
Mailing Address - Fax:765-446-5317
Practice Address - Street 1:424 W DIVISION STREET
Practice Address - Street 2:
Practice Address - City:REMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47977
Practice Address - Country:US
Practice Address - Phone:765-807-2773
Practice Address - Fax:765-807-2774
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITY HEALTHCARE,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-02
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN225X00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201152530Medicaid
IN300082826Medicaid