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1717 SENIOR LIVING, LLC
NPI 1609392422
Assisted Living Facility in Indianapolis, IN

Active since August 15, 2017CLIA 15D2131776 · Waiver
1703 WEST 86TH STREET, INDIANAPOLIS, IN 46260(317) 876-2916 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Aug 15, 2017 (2 updates tracked since 2017).

About 1717 Senior Living, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

1717 SENIOR LIVING, LLC (NPI 1609392422) is a healthcare organization registered as an assisted living facility in Indianapolis, Indiana and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through June 5, 2027 and lists Thomas Smith, President, as its authorized official.

NPPES Registry Identity

NPI1609392422
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business Name1717 SENIOR LIVING, LLC
Location Address1703 WEST 86TH STREETIndianapolis, IN 46260
Mailing Address1703 West 86th StreetIndianapolis, IN 46260 · (317) 876-2916
Phone(317) 876-2916
Organization SubpartNo
Authorized OfficialThomas SmithPresident · (317) 819-3205
Enumeration DateAugust 15, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1609392422 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
1703 WEST 86TH STREET, Indianapolis, IN 46260
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2131776

1717 Senior Living, LLC · Indianapolis, IN
Active · expires Jun 5, 2027
CLIA Number15D2131776
Laboratory TypeAssisted Living Facility
Certificate Effective DateJune 6, 2025
Certificate Expiration DateJune 5, 2027
Laboratory DirectorShelly D. Mcfall
Laboratory Phone(317) 876-2916
Laboratory Location1717 Senior Living, LLC1703 W 86th Street, Indianapolis, IN 46260
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 1717 Senior Living, LLC's NPI number?

The NPI number for 1717 Senior Living, LLC is 1609392422. It was assigned to this organization in the NPPES registry on August 15, 2017.

Where is 1717 Senior Living, LLC located?

1717 Senior Living, LLC is located at 1703 West 86th Street, Indianapolis, IN 46260. The listed phone number is (317) 876-2916.

What is 1717 Senior Living, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does 1717 Senior Living, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D2131776) is associated with this NPI, valid through June 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for 1717 Senior Living, LLC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.