GLASSWATER CREEK OF LAFAYETTE, LLC (NPI# 1285135244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285135244 |
| Entity Type | Organization |
| Organization Name | GLASSWATER CREEK OF LAFAYETTE, LLC |
| Other Organization Name | GLASSWATER CREEK OF LAFAYETTE |
| Practice Address |
208 Beck Ln Lafayette IN 47909 |
| Mailing Address |
4882 N Convent St Bourbonnais IL 60914-1461 |
| Practice Telephone | 7654771140 |
| Practice Fax Number | 7654771160 |
| Mailing Telephone | 8159351992 |
| Mailing Fax Number | 8159358380 |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | JOELLEN BLEAVINS (PRESIDENT OF MANAGEMENT AGENT) |
| Authorized Official Telephone | 8159351992 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| GLASSWATER CREEK OF LAFAYETTE | Doing Business As Name - Organization |
| Street Address |
208 BECK LN |
| City | LAFAYETTE |
| State | IN |
| Zip Code | 47909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518418680 | Dental Professionals of Indiana, PC | Dentist | 2000 Veterans Memorial Parkway S, Lafayette, IN 47909 | 2016-10-24 |
| 1013394709 | Todd Hardin | Dentist | 2 Walter Scholer Drive, Lafayette, IN 47909 | 2015-05-01 |
| 1801296967 | Lacey Hintz | Occupational Therapy Assistant | 2308 Edgelea Dr, Lafayette, IN 47909 | 2014-08-26 |
| 1457691180 | Alicia A Duncan | Lactation Consultant, Non-RN | 207 Buckingham Drive, Lafayette, IN 47909 | 2013-02-16 |
| 1558646505 | Tammie Anne Shockley | Pharmacist | 2800 Old Us 231 S, Walgreens 10974, Lafayette, IN 47909 | 2011-10-20 |
| 1952553448 | Regina R Pilotte | Occupational Therapist | 3864 East 500 South, Lafayette, IN 47909 | 2008-10-16 |
| 1811182405 | Assisted Living Concepts Inc | Assisted Living Facility | 167 West 240 South, Lafayette, IN 47909 | 2007-09-07 |
| 1073716585 | Julia Ann Dillon | Counselor | 3554 Promenade Pkwy Ste E, Lafayette, IN 47909 | 2007-06-11 |
| 1639291503 | Winifred A. Landis | Pharmacist | 2806 Us 231 South, Lafayette, IN 47909 | 2007-04-04 |
| 1124104229 | Travis B Strickler | Optometrist | 3554 Promenade Pkwy Ste A, Lafayette, IN 47909 | 2006-10-31 |
| Find all providers in zip 47909 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003431461 | Residential Care Xiii L.L.C. | Assisted Living Facility | 741 Park East Blvd, Lafayette, IN 47905-0797 | 2020-06-11 |
| 1093258782 | Lafayette Bickford Cottage, LLC | Assisted Living Facility | 3633 Regal Valley Dr, Lafayette, IN 47909-8383 | 2016-11-29 |
| 1215253984 | Stonecrest Assisted Living Facility | Assisted Living Facility | 2861 Highway 52 E, Lafayette, TN 37083-6029 | 2010-04-20 |
| 1811182405 | Assisted Living Concepts Inc | Assisted Living Facility | 167 West 240 South, Lafayette, IN 47909 | 2007-09-07 |
| 1437224029 | Fve Mw LLC | Assisted Living Facility | 250 Shenandoah Drive, Lafayette, IN 47905 | 2006-11-21 |
| 1598726671 | Lafayette Medical Investors, LLC | Assisted Living Facility | 225 Waneka Pkwy, Lafayette, CO 80026-8862 | 2006-03-29 |
| 1265832224 | 329 Exempla Circle Operations LLC | Assisted Living Facility | 329 Exempla Cir, Lafayette, CO 80026-3463 | 2014-08-27 |
| 1780746271 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 251 7th St, Lafayette, MN 56054-9782 | 2006-12-14 |
| 1669485850 | L & D Community Care | Assisted Living Facility | 101 La Rue France, Suite 100, Lafayette, LA 70508-3144 | 2006-08-15 |
| 1295748481 | L & D Community Care, Inc | Assisted Living Facility | 101 La Rue France, Suite 100, Lafayette, LA 70508-3144 | 2006-08-15 |
| Find all providers in LAFAYETTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.