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General NPI Number Information
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NPI Number | 1780995860
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Entity Type | Organization
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Legal Business Name | RSL VALPARAISO
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Dates
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Enumeration Date | 06/23/2010
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Last Update Date | 06/29/2010
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Provider Practice Location Address
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Address Line | 1300 VALE PARK RD
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City | VALPARAISO
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State | IN
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Zip | 46383-2722
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Country | US
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Telephone | 219-531-2484
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Fax | 219-531-2485
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Provider Business Mailing Address
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Address Line | 1300 VALE PARK RD
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City | VALPARAISO
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State | IN
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Zip | 46383-2722
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Country | US
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Telephone | 219-531-2484
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Fax | 219-531-2485
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LEE E SEFLERS
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Credential | MPA
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Telephone | 219-531-2484
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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 | 10-012181-1
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License Number State | IN
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