Healthcare Provider Details

I. General information

NPI: 1013555127
Provider Name (Legal Business Name): GREEN SPRINGS HEALTH & REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2019
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N BROADWAY ST
GREEN SPRINGS OH
44836-9653
US

IV. Provider business mailing address

4270 N MERIDIAN ST
INDIANAPOLIS IN
46208-3789
US

V. Phone/Fax

Practice location:
  • Phone: 419-639-2626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TIM SADLER
Title or Position: MEMBER
Credential:
Phone: 317-590-3573