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General NPI Number Information
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NPI Number | 1497740633
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Entity Type | Organization
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Legal Business Name | WESTMINSTER VILLAGE WEST LAFAYETTE, INC
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2741 N SALISBURY ST
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-1431
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Country | US
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Telephone | 765-463-7546
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Fax | 765-463-6846
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Provider Business Mailing Address
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Address Line | 2741 N SALISBURY ST
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City | WEST LAFAYETTE
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State | IN
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Zip | 47906-1431
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Country | US
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Telephone | 765-463-7546
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Fax | 765-463-6846
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Authorized Official
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Title or Position | HEALTH CARE ADMINISTRATOR
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Name | MRS. JUDY BANE
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Credential |
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Telephone | 765-463-7546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 050000931
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License Number State | IN
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