| NPI | 1326809971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA A ANDEDRSON CEO 317-361-6988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251T00000X Program of All-Inclusive Care for the Elderly (PACE) Provider Organization | |
| 253Z00000X In Home Supportive Care | |
| 305R00000X Preferred Provider Organization | |
| 310400000X Assisted Living Facility | |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 385H00000X Respite Care | |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |