MEDICARE: CATHEDRALROCK

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	050003591	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	IN000359	OTHER	IN	FACILITY ID TRANSMISSION

General Provider Information

NPI Number	:	1891781985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHEDRALROCK

Provider Business Mailing Address
First Line	:	306 W 7TH ST
Second Line	:	415 FORT WORTH CLUB BUILDING
City	:	FORT WORTH
State	:	TX
Zip	:	76102-4900
Country	:	US
Telephone Number	:	817-335-4111
Fax Number	:	817-335-0800

Provider Business Practice Location Address
First Line	:	300 E PRAIRIE ST
Second Line	:
City	:	WARSAW
State	:	IN
Zip	:	46580-4429
Country	:	US
Telephone Number	:	574-267-8922
Fax Number	:	574-268-2711

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KENT HARRINGTON
Credential	:
Telephone Number	:	817-335-4111

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	06/26/2008

Similar Medicare Providers

1114125689 — ADAMS COUNTY MEMORIAL HOSPITAL
Practice Location Address:

300 E PRAIRIE ST
WARSAW, IN
46580-4429

Practice Phone: 574-267-8922
Practice Fax: 574-258-2711

1255766002 — ELIZABETH ANN JACKSON COTA
Practice Location Address:

300 E PRAIRIE ST
WARSAW, IN
46580-4429

Practice Phone: 260-578-1380
Practice Fax:

1902200215 — MS. JOYCE ELAINE OPPY COTA
Practice Location Address:

300 E PRAIRIE ST
WARSAW, IN
46580-4429

Practice Phone: 574-267-8922
Practice Fax:

1245898618 — ELIZABETH CABELLO M.S., CCC-SLP
Practice Location Address:

300 E PRAIRIE ST
WARSAW, IN
46580-4429

Practice Phone: 574-267-8922
Practice Fax:

1336008879 — MARISA CACAHUA
Practice Location Address:

1535 PROVIDENT DR
WARSAW, IN
46580-3294

Practice Phone: 574-387-4313
Practice Fax:

1275338824 — NICHOLAS PRATER
Practice Location Address:

109 E WINONA AVE
WARSAW, IN
46580-4400

Practice Phone: 574-387-4313
Practice Fax: 574-204-2868

Directions to “CATHEDRALROCK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.