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General NPI Number Information
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NPI Number | 1538909981
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Entity Type | Organization
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Legal Business Name | MELROSE ASSISTED LIVING, LLC
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Dates
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Enumeration Date | 05/31/2024
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 7101 HIGHWAY 41 N
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City | EVANSVILLE
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State | IN
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Zip | 47725-1713
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Country | US
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Telephone | 812-556-4440
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Fax | 812-867-5208
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Provider Business Mailing Address
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Address Line | 7101 HIGHWAY 41 N
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City | EVANSVILLE
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State | IN
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Zip | 47725-1713
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Country | US
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Telephone | 812-556-4440
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Fax | 812-867-5208
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LESLIE M HEAD-BETHEL
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Credential | BS, RCA
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Telephone | 812-556-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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