A.I.D. RESIDENTIAL SERVICES, LLC (NPI# 1700248564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700248564 |
| Entity Type | Organization |
| Organization Name | A.I.D. RESIDENTIAL SERVICES, LLC |
| Practice Address |
10319 Dawsons Creek Blvd Ste E Fort Wayne IN 46825-1911 |
| Practice Telephone | 2604144713 |
| Mailing Telephone | 2604144713 |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |
| Authorized Official Name | CHRISTINA KINNALEY (PROGRAM ADMINISTRATOR) |
| Authorized Official Telephone | 2604443433 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
10319 DAWSONS CREEK BLVD STE E |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-1911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386953024 | National Mentor Healthcare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6008 Brandy Chase Cv, Fort Wayne, IN 46815-7601 | 2010-09-29 |
| 1255647913 | National Mentor Healthcare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 244 E Butler St, Fort Wayne, IN 46803-3308 | 2010-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749910 | Aspire Residential Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11216 Harrington Ln, Fishers, IN 46038-3208 | 2020-10-31 |
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1619528700 | A Totality of Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4302 Parrish Ave, East Chicago, IN 46312-3031 | 2019-09-20 |
| 1750851192 | Stimuli Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6670 Kinnerton Dr, Indianapolis, IN 46254-5843 | 2018-11-28 |
| 1659847168 | Assured Residential and Consulting, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5555 N Tacoma Ave Ste 101, Indianapolis, IN 46220-3551 | 2018-10-23 |
| 1427560002 | Swan Garden Home Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4906 Quail Ridge Ln, Indianapolis, IN 46254 | 2017-11-03 |
| 1477063923 | Gray Residential Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9660 Commerce Dr, Carmel, IN 46032-7641 | 2017-10-10 |
| 1518338664 | First Steps | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 57358 Sequoia Dr, Goshen, IN 46528-8829 | 2015-10-15 |
| 1497144042 | Jennifer Whitlow | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6710 Waverhill Dr, Indianapolis, IN 46217-9101 | 2015-01-21 |
| 1174948202 | New Roots Behavior Strategies LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13448 Fulton Drive, Fishers, IN 46038 | 2014-02-26 |
| Find all providers with the same taxonomy | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
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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.