Organization Active NPI

A Village of Love Residential LLC

  • Personal Care Attendant
  • Indianapolis, IN
National Provider Identifier
1003645953
Registry record updated Jul 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Care AttendantTaxonomy code 3747P1801X
Legal business name
A VILLAGE OF LOVE RESIDENTIAL LLC
Practice address
1855 Bauer Rd
Indianapolis, IN 46218-4814
Phone
(317) 625-4130
NPI assigned
Jul 30, 2024
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Bobby Joe TyusNPI 1689403537
Title
President
Phone
(317) 625-4130

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

National Provider Directory

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care AttendantGroup: 193400000X SINGLE SPECIALTY GROUP 3747P1801X Primary

Addresses

NPPES NPI Registry

Primary practice location

1855 Bauer Rd
Indianapolis, IN 46218-4814

Mailing address

1855 Bauer Rd
Indianapolis, IN 46218-4814
Phone (317) 625-4130

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 30, 2024.

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722297600000",
    "number": "1003645953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 BAUER RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462184814",
            "telephone_number": "317-625-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 BAUER RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462184814",
            "telephone_number": "317-625-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A VILLAGE OF LOVE RESIDENTIAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A",
        "authorized_official_last_name": "TYUS",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-625-4130"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.