Glasswater Creek of Lafayette, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GLASSWATER CREEK OF LAFAYETTE, LLC

Practice address

208 Beck LN
Lafayette, IN 47909

Phone

(765) 477-1140

Fax

(765) 477-1160

NPI assigned

Feb 26, 2018

Organization subpart

No

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

Authorized official

Name

Greg Echols

Title

Co-President of Management Agent

Phone

(815) 935-1992

Specialties & licenses 1

Addresses

Other names 1

• GLASSWATER CREEK OF LAFAYETTE 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

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1285135244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E COURT ST STE 400",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013848",
            "telephone_number": "815-935-1992",
            "fax_number": "815-935-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 BECK LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "47909",
            "telephone_number": "765-477-1140",
            "fax_number": "765-477-1160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASSWATER CREEK OF LAFAYETTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-26",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "ECHOLS",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "CO-PRESIDENT OF MANAGEMENT AGENT",
        "authorized_official_telephone_number": "815-935-1992"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLASSWATER CREEK OF LAFAYETTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Gillespie, PT, DPT
• Nicole Gilmore, PHARMD
• Gianna Giovanello
• Antonio Jose Giron
• Emma Rosa Giron, DTA
• GLHS Anesthesia Group
• Kayla Le Anne Glover, BSN, RN
• Pradeep Gnanapragasam, M.D.,
• Rachel Marie Goad, DDS
• Lori Goebel

• Assisted Living Facility in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.