CAPITOL CITY RESIDENTIAL HEALTH CARE LLC (NPI# 1790994796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790994796 |
Entity Type | Organization |
Organization Name | CAPITOL CITY RESIDENTIAL HEALTH CARE LLC |
Practice Address |
1608 E 10th St Indianapolis IN 46201-1902 |
Practice Telephone | 3176321851 |
Practice Fax Number | 8664807748 |
Mailing Telephone | 3176321851 |
Mailing Fax Number | 8664807748 |
Enumeration Date | 2007-05-22 |
Last Update Date | 2020-08-22 |
Authorized Official Name | KELLEE R. DERICO (ADMINISTRATOR) |
Authorized Official Telephone | 3176321851 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
IN | Nursing & Custodial Care Facilities |
Street Address |
1608 E 10TH ST |
City | INDIANAPOLIS |
State | IN |
Zip Code | 46201-1902 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457876575 | Alyssia Hawthorne | Contractor | 810 N Bosart, Indianapolis, IN 46201 | 2017-08-09 |
1710221833 | Candace D Clayton | Specialist/Technologist | 1500 E. Michigan St, Arsenal Tech West Gym Atr, Indianapolis, IN 46201 | 2012-11-15 |
1427211739 | Vanessa Antonie Flora | Physical Therapist | 1001 W 10th Street, Indianapolis, IN 46201 | 2008-07-07 |
1194993642 | Steve C. Linville | Counselor | 5049 E. 11th Street, Indianapolis, IN 46201 | 2008-02-19 |
1336355023 | Brenda Gay Barker | Family Medicine | 11 N Eastern Avenue, Good Samaritan Health Clinic, Indianapolis, IN 46201 | 2007-05-16 |
1447541347 | Kimberly Denise Wolfe | Registered Nurse | 1776 Brookside Ave, Indianapolis, IN 46201-1018 | 2011-04-26 |
1235645318 | Armaryllis Y Lewis | Counselor | 1402 Commerce Ave, Indianapolis, IN 46201-1141 | 2017-12-27 |
1184160608 | Sarah Ann Battista | Registered Nurse | 1250 N State Ave, Indianapolis, IN 46201-1162 | 2017-01-07 |
1821330234 | Kindra Marie Hunckler | Doula | 1115 N Tacoma Ave, Indianapolis, IN 46201-1334 | 2013-03-24 |
1497279897 | Timothy Barnes | Respite Care | 1406 N Dearborn St, Indianapolis, IN 46201-1412 | 2017-07-28 |
Find all providers in zip 46201 |
Taxonomy Code | 3104A0625X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Assisted Living Facility |
Specialization | Assisted Living, Mental Illness |
A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407919806 | Home Med Pharmacy LLC | Assisted Living Facility | 6210 Technology Center Dr, Indianapolis, IN 46278 | 2006-12-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891274882 | Wow Factor Winning Options In Wellness | Assisted Living Facility | 301 Hamlin St, Gary, IN 46406-1338 | 2018-08-09 |
1205315033 | Michiana Mental Health Care, LLC. | Assisted Living Facility | 210 S Race St, Mishawaka, IN 46544 | 2018-08-13 |
1285038703 | Oluseye Lawal | Assisted Living Facility | 1100 W 6th Ave, Gary, IN 46402-1711 | 2014-10-13 |
1346649688 | Heather Carroll | Assisted Living Facility | 430 E Cleveland Rd, Granger, IN 46530-5624 | 2014-08-21 |
City | INDIANAPOLIS |
Zip Code | 46201 |
Please comment or provide details below to improve the information on CAPITOL CITY RESIDENTIAL HEALTH CARE LLC.
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.