MEDICARE: GENERATIONS ADULT DAY CENTER 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	261QA0600X	Adult Day Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740094309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERATIONS ADULT DAY CENTER LLC

Provider Business Mailing Address
First Line	:	5731 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-6521
Country	:	US
Telephone Number	:	317-682-7394
Fax Number	:

Provider Business Practice Location Address
First Line	:	5731 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-6521
Country	:	US
Telephone Number	:	463-223-9595
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PATRICE PADRON
Credential	:
Telephone Number	:	317-682-7394

Provider Enumeration Date	:	02/04/2025
Last Update Date	:	02/04/2025

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