MEDICARE: RESIDENCE PARK SENIOR CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1356289854
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESIDENCE PARK SENIOR CARE, LLC

Provider Business Mailing Address
First Line	:	4420 PEPPERIDGE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-1238
Country	:	US
Telephone Number	:	317-603-7399
Fax Number	:

Provider Business Practice Location Address
First Line	:	4420 PEPPERIDGE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235-1238
Country	:	US
Telephone Number	:	317-603-7399
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DENISE PARKER
Credential	:
Telephone Number	:	317-603-7399

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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