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Organization

A VILLAGE OF LOVE RESIDENTIAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BOBBY JOE TYUS (PRESIDENT)
(317) 625-4130
Entity
Organization

Contact information

Practice address
1855 BAUER RD, INDIANAPOLIS, IN 46218-4814
(317) 625-4130
Mailing address
1855 BAUER RD, INDIANAPOLIS, IN 46218-4814
(317) 625-4130

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Enumeration date
07/30/2024
Last updated
07/30/2024
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