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NPI Code Detail

MEDICARE: MERCY LONG TERM CARE INITIATIVES, INC.

MEDICARE: MERCY LONG TERM CARE INITIATIVES, 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
1313M00000XNursing Facility/Intermediate Care FacilityIN

General Provider Information

NPI Number : 1992792303
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERCY LONG TERM CARE INITIATIVES, INC.
Provider Business Mailing Address
First Line : 4915 CHARLESTOWN RD
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-9426
Country : US
Telephone Number : 812-945-5221
Fax Number : 812-945-2614
Provider Business Practice Location Address
First Line : 4915 CHARLESTOWN RD
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-9426
Country : US
Telephone Number : 812-945-5221
Fax Number : 812-945-2614
Authorized Official
Title or Position : CFO
Name : MR. WILLIAM ROBERT LEE
Credential : CPA
Telephone Number : 812-945-5221
Provider Enumeration Date : 09/30/2005
Last Update Date : 08/22/2020

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Directions to “MERCY LONG TERM CARE INITIATIVES, INC. ” Practice Location

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