| NPI | 1902859846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY L HICKS President 317-630-3156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX Pending) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-08-22 |