GRAND BROOK MEMORY CARE OF FISHERS LLC NPI 1508461062

NPI Information

NPI: 1508461062
Provider Name: GRAND BROOK MEMORY CARE OF FISHERS, LLC
Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 15D2154544

Address:
9796 E 131ST ST
FISHERS, IN
ZIP 46038
Phone: (317) 827-6853
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GRAND BROOK MEMORY CARE OF FISHERS, LLC is an assisted living facility in Fishers, IN. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. GRAND BROOK MEMORY CARE OF FISHERS, LLC NPI is 1508461062. The provider is registered as an organization entity type.

The provider's business location address is:

9796 E 131ST ST
FISHERS, IN
ZIP 46038-601
Phone: (317) 827-6853

The provider's authorized official is Chad Anderson .
The authorized official title is President and has the following contact phone number (469) 331-8200.

The CLIA number assigned to this NPI record is 15D2154544 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/2/2020 and was last updated on 12/2/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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