Embolden Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EMBOLDEN SENIOR LIVING LLC

Doing business as

Jewel Place Senior Living

Practice address

607 Virginia Ave
Madison, IN 47250-3847

Phone

(812) 273-0432

NPI assigned

Feb 6, 2024

Organization subpart

No

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

Authorized official

Name

Marla Cook

Title

Member

Phone

(765) 744-0687

Specialties & licenses 1

Addresses

Other names 1

• Jewel Place Senior Living 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": "1707177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1629831110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 E MILLER ST UNIT A",
            "city": "SELMA",
            "state": "IN",
            "postal_code": "473839630",
            "telephone_number": "765-744-0687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 VIRGINIA AVE",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472503847",
            "telephone_number": "812-273-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBOLDEN SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "MARLA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "765-744-0687"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jewel Place Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• E S T Inc
• John M Eagleson, OD
• Thomas C Eckert, M.D.
• Robert M. Ellis, M.D.
• Dylan R Emanuel
• Jennifer Engelhard
• Extra Special Parents of Indiana, LLC
• Eye Associates of Southern Indiana PC
• Family Friends Homecare & Assistance LLC
• Areej Fatima, PA-C

• Assisted Living Facility in Madison, IN
• Providers in Madison, 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 Feb 6, 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.