MEDICARE: BHI SENIOR LIVING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	06-000543-1	IN

General Provider Information

NPI Number	:	1568572287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BHI SENIOR LIVING, INC.

Provider Business Mailing Address
First Line	:	5415 BEARBERRY LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-3922
Country	:	US
Telephone Number	:	317-873-3371
Fax Number	:	317-873-4856

Provider Business Practice Location Address
First Line	:	1901 TAYLOR RD
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47203-3908
Country	:	US
Telephone Number	:	812-372-8481
Fax Number	:	812-378-6184

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	RICHARD H. KEENAN
Credential	:
Telephone Number	:	317-873-3371

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/26/2015

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