# FOREST ACADEMY

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

## Provider details

- **NPI number:** 1831873801
- **Authorized official:** GRETCHEN SHISSLER MOTR/L (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (765) 414-0125

## Contact information

- **Practice address:** 8439 STATE ROAD 26 E, LAFAYETTE, IN 47905-9519
- **Practice address phone:** (765) 414-0125
- **Mailing address:** 44 JESTER CT, LAFAYETTE, IN 47905-7608
- **Mailing address phone:** (765) 414-0125

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/12/2023
- **Last updated:** 06/12/2023