Provider Demographics
NPI:1437290012
Name:RESIDENTIAL CRF, INC.
Entity Type:Organization
Organization Name:RESIDENTIAL CRF, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAUGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-825-5129
Mailing Address - Street 1:1117 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-2126
Mailing Address - Country:US
Mailing Address - Phone:765-825-5129
Mailing Address - Fax:765-825-0074
Practice Address - Street 1:622 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173-1642
Practice Address - Country:US
Practice Address - Phone:765-932-2678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities