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General NPI Number Information
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NPI Number | 1902920440
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Entity Type | Organization
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Legal Business Name | ASSISTED LIVING SERVICES LLC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3411 MEYERS GRV
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City | SELLERSBURG
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State | IN
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Zip | 47172-9155
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Country | US
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Telephone | 812-246-5934
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Fax |
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Provider Business Mailing Address
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Address Line | 3411 MEYERS GRV
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City | SELLERSBURG
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State | IN
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Zip | 47172-9155
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Country | US
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Telephone | 812-246-5934
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Fax |
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Authorized Official
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Title or Position | GENERAL PARTNER - PRESIDENT
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Name | PAULA HARTMAN
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Credential | RN, CPNP
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Telephone | 812-246-5934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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