Provider Demographics
NPI:1003431461
Name:RESIDENTIAL CARE XIII L.L.C.
Entity Type:Organization
Organization Name:RESIDENTIAL CARE XIII L.L.C.
Other - Org Name:ASTER PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO OF ASC
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:317-788-2500
Mailing Address - Street 1:741 PARK EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-0797
Mailing Address - Country:US
Mailing Address - Phone:765-446-3540
Mailing Address - Fax:765-446-9500
Practice Address - Street 1:741 PARK EAST BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-0797
Practice Address - Country:US
Practice Address - Phone:765-446-3540
Practice Address - Fax:765-446-9500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300030263Medicaid