NPI: 1700248564 · FORT WAYNE, IN 46825 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI assigned 03/22/2016
| Authorized Official | KINNALEY, CHRISTINA (PROGRAM ADMINISTRATOR) |
| NPI Enumeration Date | 03/22/2016 |
| Year | Claims | Total Paid |
|---|---|---|
| 2018 | 3,593 | $2.34M |
| 2019 | 5,963 | $2.80M |
| 2020 | 13,225 | $6.12M |
| 2021 | 11,671 | $5.15M |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2016 | Habilitation, residential, waiver; per diem | 9,540 | 2,040 | $12.22M |
| T2033 | Residential care, not otherwise specified (nos), waiver; per diem | 7,656 | 2,313 | $1.81M |
| S5151 | Unskilled respite care, not hospice; per diem | 2,609 | 816 | $1.17M |
| T2020 | Day habilitation, waiver; per diem | 5,844 | 1,570 | $661K |
| T2002 | Non-emergency transportation; per diem | 7,372 | 1,748 | $352K |
| T2022 | Case management, per month | 1,431 | 1,370 | $191K |