# ADEC - VILLAGE MEN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275757643
- **Authorized official:** PAULA M SHIVELY (CEO)
- **Authorized official phone:** (574) 848-7451

## Contact information

- **Practice address:** 19816 STATE ROAD 120 \#3, BRISTOL, IN 46507
- **Practice address phone:** (574) 848-5751
- **Practice address fax:** (574) 848-5917
- **Mailing address:** 19670 ST RD 120, BRISTOL, IN 46507-0398
- **Mailing address phone:** (574) 848-7451
- **Mailing address fax:** (574) 848-5917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 2670I0004JN08 | IN | Yes |

## Other

- **Enumeration date:** 04/13/2007
- **Last updated:** 08/22/2020