Healthcare Provider Details

I. General information

NPI: 1316150568
Provider Name (Legal Business Name): HEALTHCARE CENTERS OF INDIANA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 03/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

958 HIGHWAY 46 E
BATESVILLE IN
47006-7600
US

IV. Provider business mailing address

300 GLEED AVE
EAST AURORA NY
14052-2983
US

V. Phone/Fax

Practice location:
  • Phone: 812-934-2436
  • Fax: 812-934-0667
Mailing address:
  • Phone: 716-652-2820
  • Fax: 716-655-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number05-000138-1
License Number StateIN

VIII. Authorized Official

Name: MRS. JOY A FELDMAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 716-805-1474