Provider Demographics
NPI:1740052653
Name:MAJESTICS LIFE RESIDENTIAL SERVICES
Entity type:Organization
Organization Name:MAJESTICS LIFE RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-606-2888
Mailing Address - Street 1:301 E CARMEL DR STE E300
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-4817
Mailing Address - Country:US
Mailing Address - Phone:317-606-2888
Mailing Address - Fax:317-606-2888
Practice Address - Street 1:301 E CARMEL DR STE E300
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-4817
Practice Address - Country:US
Practice Address - Phone:317-606-2888
Practice Address - Fax:317-606-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities