Healthcare Provider Details

I. General information

NPI: 1114853496
Provider Name (Legal Business Name): SABRA INDIANA OPERATIONS I, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 PARK PLACE DR
FORT WAYNE IN
46845-8793
US

IV. Provider business mailing address

4411 PARK PLACE DR
FORT WAYNE IN
46845-8793
US

V. Phone/Fax

Practice location:
  • Phone: 260-480-2500
  • Fax:
Mailing address:
  • Phone: 260-452-4896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: KRIS PETERS
Title or Position: DIRECTOR OF BUSINESS OFFICE
Credential:
Phone: 260-452-4896