MEDICARE: PARADIGM LIVING CONCEPTS, 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1669186334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARADIGM LIVING CONCEPTS, LLC

Provider Business Mailing Address
First Line	:	8904 BASH ST STE B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-1286
Country	:	US
Telephone Number	:	317-735-6001
Fax Number	:	855-450-1177

Provider Business Practice Location Address
First Line	:	10020 LIMA RD STE D
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46818-9144
Country	:	US
Telephone Number	:	317-735-6001
Fax Number	:	855-450-1177

Authorized Official
Title or Position	:	PRESIDENT / CEO
Name	:	JEFFREY NOAH JARECKI
Credential	:	MBA
Telephone Number	:	317-735-6001

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	09/15/2023

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