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NPI Code Detail

MEDICARE: RESIDENTIAL CRF, INC

MEDICARE: RESIDENTIAL CRF, INC
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
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility1835362IN

General Provider Information

NPI Number : 1942306790
Entity Type Code : Organization
Provider Name (Legal Business Name) : RESIDENTIAL CRF, INC
Provider Business Mailing Address
First Line : 1117 N CENTRAL AVE
Second Line :
City : CONNERSVILLE
State : IN
Zip : 47331-2126
Country : US
Telephone Number : 765-827-6996
Fax Number : 765-827-5809
Provider Business Practice Location Address
First Line : 624 UNIVERSITY AVE
Second Line : SUITE 500
City : LAS VEGAS
State : NM
Zip : 87701-4278
Country : US
Telephone Number : 505-425-5429
Fax Number : 505-425-5379
Authorized Official
Title or Position : ACCOUNTING ASSISTANT
Name : MS. KIM WRIGHT
Credential :
Telephone Number : 765-827-6996
Provider Enumeration Date : 09/16/2006
Last Update Date : 09/06/2023

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Directions to “RESIDENTIAL CRF, INC ” Practice Location

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