Healthcare Provider Details

I. General information

NPI: 1255441663
Provider Name (Legal Business Name): BHI SENIOR LIVING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 SAINT JOE CENTER RD
FORT WAYNE IN
46825-5061
US

IV. Provider business mailing address

5415 BEARBERRY LN
INDIANAPOLIS IN
46268-3922
US

V. Phone/Fax

Practice location:
  • Phone: 260-483-3116
  • Fax: 260-873-9156
Mailing address:
  • Phone: 317-873-3371
  • Fax: 317-873-4856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number05-000541-1
License Number StateIN

VIII. Authorized Official

Name: ROGER WEIDEMAN
Title or Position: CFO
Credential:
Phone: 317-873-3371