Residential Care XII L.L.C.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

RESIDENTIAL CARE XII L.L.C.

Practice address

9107 Taylorsville Rd
Louisville, KY 40299-1751

Phone

(502) 499-5533

Fax

(502) 313-0299

NPI assigned

Sep 2, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steve Van Camp, CPA

Title

Cfo of ASC

Phone

(317) 788-2500

Specialties & licenses 1

Addresses

Other names 1

• Forest Hills Commons Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1134733686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9107 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991751",
            "telephone_number": "502-499-5533",
            "fax_number": "502-313-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9107 TAYLORSVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991751",
            "telephone_number": "502-499-5533",
            "fax_number": "502-313-0299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL CARE XII L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "VAN CAMP",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CFO OF ASC",
        "authorized_official_telephone_number": "317-788-2500",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Hills Commons",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Forest Hills Commons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby Reppen
• Devin Cruz Repuyan, MD
• Courtney Caree Rerecich, PHARMD
• Res-Care, Inc
• Mary Danielle Resch, BCBA
• Resilience Therapy Services, LLC
• Resilience Way
• Resilience Way Mental Health Therapy & Self-Care Agency
• Resilient Minds LLC
• Resources for Education, Adaptation, Change, and Health, Inc.

• Assisted Living Facility in Louisville, KY
• Providers in Louisville, KY by specialty
• Assisted Living Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.