Provider Demographics
NPI:1598379042
Name:RESIDENTIAL CARE XI L.L.C.
Entity Type:Organization
Organization Name:RESIDENTIAL CARE XI L.L.C.
Other - Org Name:ALLISONVILLE MEADOWS ASSISTED LIVING
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 1:10410 ALLISONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2017
Mailing Address - Country:US
Mailing Address - Phone:317-436-6400
Mailing Address - Fax:317-436-6401
Practice Address - Street 1:10410 ALLISONVILLE RD
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2017
Practice Address - Country:US
Practice Address - Phone:317-436-6400
Practice Address - Fax:317-436-6401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-02
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility