NPI | 1811970569 |
---|---|
Entity Type | Organization |
Authorized Contact | KEITH J DETRUDE President 317-573-3895 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: IN 05-000105-1) |
Enumeration Date | 2005-11-28 |
Last Update Date | 2019-08-28 |