Provider Demographics
NPI:1770396178
Name:CRAWFORDSVILLE SENIOR OPCO, LLC
Entity type:Organization
Organization Name:CRAWFORDSVILLE SENIOR OPCO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KESLER
Authorized Official - Suffix:
Authorized Official - Credentials:HFA
Authorized Official - Phone:317-529-6187
Mailing Address - Street 1:225 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:FORTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46040-1504
Mailing Address - Country:US
Mailing Address - Phone:317-529-6187
Mailing Address - Fax:
Practice Address - Street 1:100 BICKFORD LN
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-2186
Practice Address - Country:US
Practice Address - Phone:765-362-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility