Nellis Adult Daycare LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

201008180A Issued in IN

Legal business name

NELLIS ADULT DAYCARE LLC

Practice address

1902 Virginia Ave
Connersville, IN 47331-2834

Phone

(765) 692-0260

Fax

(765) 692-0261

NPI assigned

Mar 11, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Suzanne Carol Ellis, RN

Title

Exectutive Director

Phone

(765) 692-0260

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1164720371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312834",
            "telephone_number": "765-692-0260",
            "fax_number": "765-692-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 VIRGINIA AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473312834",
            "telephone_number": "765-692-0260",
            "fax_number": "765-692-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELLIS ADULT DAYCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-11",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "EXECTUTIVE DIRECTOR",
        "authorized_official_telephone_number": "765-692-0260",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "IN",
            "license": "201008180A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201008180A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Renee Miracle, D.C.
• David B Moore, DDS
• Lesley Jean Mullins, R.N., M.S., CNS.
• Emily Munson
• Neighborhood Health Center
• Brianna D Niehoff, OD
• David A. Niemiec, D.D.S.
• Katrina Norris, LCSW
• John Nwannunu, MD
• Orthopaedic Surgical Care Institute

• Alzheimer Center (Dementia Center) in Connersville, IN
• Providers in Connersville, IN by specialty
• Alzheimer Center (Dementia Center) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; 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.