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General NPI Number Information
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NPI Number | 1770396178
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Entity Type | Organization
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Legal Business Name | CRAWFORDSVILLE SENIOR OPCO, LLC
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Dates
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Enumeration Date | 01/29/2025
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 100 BICKFORD LN
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-2186
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Country | US
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Telephone | 765-362-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 225 E BROADWAY ST
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City | FORTVILLE
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State | IN
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Zip | 46040-1504
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Country | US
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Telephone | 317-529-6187
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JAMES KESLER
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Credential | HFA
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Telephone | 317-529-6187
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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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