Life's Journey of Avon, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

LIFE'S JOURNEY OF AVON, LLC

Practice address

10241 E County Road 100 N
Indianapolis, IN 46234-9016

Phone

(317) 561-6838

Fax

(317) 561-6827

NPI assigned

Sep 13, 2018

Organization subpart

No

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

Authorized official

Name

Robert D Wallace

Title

Ceo

Phone

(317) 561-6838

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1710460936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10241 E COUNTY ROAD 100 N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462349016",
            "telephone_number": "317-561-6838",
            "fax_number": "317-561-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10241 E COUNTY ROAD 100 N",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462349016",
            "telephone_number": "317-561-6838",
            "fax_number": "317-561-6827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE'S JOURNEY OF AVON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-561-6838"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.