# ADAMS COUNTY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BRECKENRIDGE HEALTH & REHABILITATION, Envive of Sullivan
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013193903
- **Authorized official:** MR. DANE E WHEELER CPA (CFO)
- **Authorized official phone:** (260) 724-2145

## Contact information

- **Practice address:** 325 WEST NORTHWOOD DRIVE, SULLIVAN, IN 47882-7515
- **Practice address phone:** (812) 268-3351
- **Practice address fax:** (812) 268-3765
- **Mailing address:** 1100 MERCER AVENUE, DECATUR, IN 46733-2303
- **Mailing address phone:** (260) 724-2145
- **Mailing address fax:** (317) 818-1762

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 110005251 | IN | Yes |

## Other

- **Enumeration date:** 01/10/2008
- **Last updated:** 08/15/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100267010B | — | IN |