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General NPI Number Information
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NPI Number | 1427058288
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Entity Type | Organization
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Legal Business Name | SWISS VILLAGE, INC.
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 1350 W MAIN ST
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City | BERNE
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State | IN
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Zip | 46711-1741
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Country | US
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Telephone | 260-589-3173
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Fax | 260-589-8369
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Provider Business Mailing Address
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Address Line | 1350 W MAIN ST
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City | BERNE
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State | IN
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Zip | 46711-1741
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Country | US
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Telephone | 260-589-3173
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Fax | 260-589-8369
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Authorized Official
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Title or Position | CONTROLLER
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Name | ROGER D YOUNG
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Credential |
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Telephone | 260-589-3173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 120002801
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 120002801
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | 120002801
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 120002801
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 120002801
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License Number State | IN
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