PARK PLACE SENIOR LIVING, LLC (NPI# 1396034237) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396034237 |
| Entity Type | Organization |
| Organization Name | PARK PLACE SENIOR LIVING, LLC |
| Practice Address |
4411 Park Place Dr Fort Wayne IN 46845-8793 |
| Practice Telephone | 2604802500 |
| Mailing Telephone | 2604802500 |
| Enumeration Date | 2011-03-31 |
| Last Update Date | 2011-03-31 |
| Authorized Official Name | MS. LACHELE R HENKLE WEAVER (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 3172587031 |
| Authorized Official Credential | HFA, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942713102 | Park Place Senior Living, LLC | Assisted Living Facility | 125 E Park St, Owatonna, MN 55060-4067 | 2017-11-09 |
| Street Address |
4411 PARK PLACE DR |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46845-8793 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881154110 | Nancy Jean Ehmke | Clinical Nurse Specialist | 11151 Parkview Plaza Dr, Fort Wayne, IN 46845 | 2019-03-22 |
| 1043703903 | Kara Stackhouse | Nurse Practitioner | 11050 Parkview Plaza Drive, Fort Wayne, IN 46845 | 2018-06-14 |
| 1871082412 | Tara K Jellison | Pharmacist | 11109 Parkview Plaza Drive -- Attn Pharmacy, Fort Wayne, IN 46845 | 2018-05-09 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1811437999 | Jessica Ann Lefever | Behavioral Analyst | 3898 New Vision Dr Ste D, Fort Wayne, IN 46845 | 2017-03-08 |
| 1033668041 | Bhi Home Care, Inc. | In Home Supportive Care | 820 Mill Lake Road, Fort Wayne, IN 46845 | 2016-10-03 |
| 1467814939 | Austin Wyss | Specialist/Technologist | 11130 Parkview Circle Drive, Ft. Wayne, IN 46845 | 2016-03-24 |
| 1154713584 | Ashley Whitcraft | Specialist/Technologist | 11130 Parkview Plaza Drive #4, Fort Wayne, IN 46845 | 2015-02-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1336482496 | Mithun Mohana Shenoi | Colon & Rectal Surgery | 11104 Parkview Circle Drive Suite 320, Fort Wayne, IN 46845 | 2013-03-27 |
| Find all providers in zip 46845 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895390 | The Health and Hospital Corporation of Marion County | Assisted Living Facility | 2002 Heritage Park Dr, Fort Wayne, IN 46805-5806 | 2020-09-10 |
| 1730712886 | Cook Road Aal Lp | Assisted Living Facility | 3731 W Cook Rd, Fort Wayne, IN 46818-9403 | 2020-02-18 |
| 1194358119 | Ev Fw Limited Partnership | Assisted Living Facility | 12523 Auburn Rd, Fort Wayne, IN 46845-8797 | 2020-02-18 |
| 1073006938 | Fort Wayne Aal Lp | Assisted Living Facility | 7125 S Hanna Street, Fort Wayne, IN 46816 | 2018-06-14 |
| 1801205240 | Pulaski Memorial Hospital | Assisted Living Facility | 5250 Heritage Pkwy, Fort Wayne, IN 46835-1061 | 2014-08-11 |
| 1083036974 | Capital Senior Living Properties 4, Inc. | Assisted Living Facility | 3320 East State Boulevard, Fort Wayne, IN 46805 | 2014-01-10 |
| 1063701886 | Lamplight Inn of Fort Wayne, LLC | Assisted Living Facility | 300 E Washington Blvd, Fort Wayne, IN 46802-3124 | 2011-04-01 |
| 1225212475 | The Health and Hospital Corporation of Marion County | Assisted Living Facility | 7833 W. Jefferson Blvd, Fort Wayne, IN 46804 | 2007-12-24 |
| 1093900672 | Assisted Living Concepts Inc | Assisted Living Facility | 2116 Butler Road, Fort Wayne, IN 47150 | 2007-09-07 |
| 1841365434 | Five Star Quality Care - Obx Operator, LLC | Assisted Living Facility | 2601 Covington Commons Drive, Fort Wayne, IN 46804 | 2006-11-21 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46845 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.