Provider Demographics
NPI:1679329445
Name:RESIDENTIAL CARE XV, LLC
Entity Type:Organization
Organization Name:RESIDENTIAL CARE XV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIELD ACCT
Authorized Official - Prefix:
Authorized Official - First Name:SHERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:SR VP
Authorized Official - Phone:317-788-2500
Mailing Address - Street 1:6900 GRAY RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46237-3209
Mailing Address - Country:US
Mailing Address - Phone:317-788-2500
Mailing Address - Fax:317-788-2509
Practice Address - Street 1:6900 GRAY RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46237-3209
Practice Address - Country:US
Practice Address - Phone:317-788-2500
Practice Address - Fax:317-788-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility