Healthcare Provider Details

I. General information

NPI: 1891940979
Provider Name (Legal Business Name): RITTENHOUSE SENIOR LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2008
Last Update Date: 11/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1251 W 96TH ST
INDIANAPOLIS IN
46260-1181
US

IV. Provider business mailing address

1251 W 96TH ST
INDIANAPOLIS IN
46260-1181
US

V. Phone/Fax

Practice location:
  • Phone: 317-575-9200
  • Fax: 317-575-8209
Mailing address:
  • Phone: 317-575-9200
  • Fax: 317-575-8209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number08-003282-2
License Number StateIN

VIII. Authorized Official

Name: MS. LAURA L FRANK
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 317-575-9200