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General NPI Number Information
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NPI Number | 1831196369
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Entity Type | Organization
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Legal Business Name | UNIVERSITY PLACE, INC
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 1750 LINDBERG RD
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-4956
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Country | US
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Telephone | 765-464-5600
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Fax | 765-464-5605
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Provider Business Mailing Address
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Address Line | 1700 LINDBERG RD
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-7317
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Country | US
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Telephone | 765-464-5600
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Fax | 765-464-5605
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Authorized Official
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Title or Position | PRESIDENT AND C.E.O.
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Name | MRS. JUDY AMIANO
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Credential |
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Telephone | 331-318-5200
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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 | 050036731
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 080036731
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License Number State | IN
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