MEDICARE: ADVANCING RESIDENTIAL CARE

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1639907348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCING RESIDENTIAL CARE

Provider Business Mailing Address
First Line	:	6002 W 62ND ST STE B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-2909
Country	:	US
Telephone Number	:	317-960-6114
Fax Number	:

Provider Business Practice Location Address
First Line	:	6002 W 62ND ST STE B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46278-2909
Country	:	US
Telephone Number	:	317-960-6114
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. SHAUNA R LIPSCOMB
Credential	:
Telephone Number	:	317-960-6114

Provider Enumeration Date	:	07/24/2024
Last Update Date	:	07/24/2024

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