| NPI | 1770035982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN FOSTER COO 317-786-3230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: WI 3188) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2018-10-15 |