Organization Active NPI

Lavish Royalty Disability Solutions LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Fort Wayne, IN
National Provider Identifier
1629941075
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
LAVISH ROYALTY DISABILITY SOLUTIONS LLC
Practice address
10439 W State Road 14
Fort Wayne, IN 46814-9181
Phone
(574) 971-1610
NPI assigned
Sep 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Authorized official

Name
Kaeisha Murdock
Title
Director
Phone
(574) 971-1610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

10439 W State Road 14
Fort Wayne, IN 46814-9181

Mailing address

10439 W State Road 14
Fort Wayne, IN 46814-9181

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758585600000",
    "number": "1629941075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10439 W STATE ROAD 14",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10439 W STATE ROAD 14",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468149181",
            "telephone_number": "574-971-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVISH ROYALTY DISABILITY SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A",
        "authorized_official_last_name": "MURDOCK",
        "authorized_official_first_name": "KAEISHA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "574-971-1610"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; 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.