Healthcare Provider Details

I. General information

NPI: 1689016594
Provider Name (Legal Business Name): MAYFLOWER COMMUNITIES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 S GUILFORD RD
CARMEL IN
46032-2810
US

IV. Provider business mailing address

1335 S GUILFORD RD
CARMEL IN
46032-2810
US

V. Phone/Fax

Practice location:
  • Phone: 317-706-6760
  • Fax: 317-706-6761
Mailing address:
  • Phone: 317-706-6760
  • Fax: 317-706-6761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. TROY CANNADAY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 317-706-6760