611 W COUNTY LINE RD SOUTH TENANT LLC
NPI 1366256794
Assisted Living Facility in Fort Wayne, IN

NPI Status: Active since February 05, 2025

Contact Information

611 W COUNTY LINE RD S
FORT WAYNE, IN
ZIP 46814
Phone: (260) 625-4025

NPI Profile Information
Primary Taxonomy
Authorized Official
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Assisted Living Facility

About 611 W COUNTY LINE RD SOUTH TENANT LLC

This page provides the complete NPI Profile along with additional information for 611 W County Line Rd South Tenant Llc, a provider established in Fort Wayne, Indiana operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1366256794 assigned on February 2025. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated February 2025. The authorized official of this NPI record is Laura Lovell (Executive Director)

NPI: 1366256794
Provider Name: 611 W COUNTY LINE RD SOUTH TENANT LLC
Entity Type: Organization
Location Address: 611 W COUNTY LINE RD S FORT WAYNE, IN 46814
Location Phone: (260) 625-4025
Mailing Address: 611 W COUNTY LINE RD S FORT WAYNE, IN 46814
Mailing Phone: (260) 625-4025
Is Sole Proprietor?: No
Is Organization Subpart?: No
Enumeration Date: 02-05-2025
Last Update Date: 02-05-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Assisted Living Facility
Taxonomy Code: 310400000X
Type: Nursing & Custodial Care Facilities
Taxonomy Description: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: LAURA LOVELL
Authorized Official Title: EXECUTIVE DIRECTOR
Authorized Official Phone: (260) 625-4025

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	3	6	6	2	5	6	7	9	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	3	12	6	4	5	12	7	18
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 2 + 6 + 4 + 5 + 1 + 2 + 7 + 1 + 8 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 4									4

The NPI number 1366256794 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.