| NPI | 1285805275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | C DIEDERICK VAN DER VELDE Owner 317-882-5455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: IN 080114781) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |