# EASTGATE MANOR

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003162512
- **Authorized official:** MS. SABRINA MARIE JOHNSON PTA (FACILITY REHAB COORDINATOR)
- **Authorized official phone:** (812) 254-3301

## Contact information

- **Practice address:** 2119 E NATIONAL HWY, WASHINGTON, IN 47501-4507
- **Practice address phone:** (812) 254-3301
- **Practice address fax:** (812) 257-0039
- **Mailing address:** 2119 E NATIONAL HWY, WASHINGTON, IN 47501-4507
- **Mailing address phone:** (812) 254-3301
- **Mailing address fax:** (812) 257-0039

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 46002337A | IN | Yes |

## Other

- **Enumeration date:** 08/02/2012
- **Last updated:** 08/02/2012