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Organization
VOCA OF INDIANA LLC
Active
Organization
VOCA OF INDIANA LLC
Active
Other names
COUNTRY SQUIRE
Organization subpart
No
Provider details
NPI number
Authorized official
DENISHA CONNOR (PROVIDER ENROLLMENT)
(502) 630-7421
Entity
Organization
Contact information
Practice address
153 WHITE OAK WAY, NORTH VERNON, IN 47265-8742
(812) 273-0523
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100240180B
—
IN
Enumeration date
03/27/2007
Last updated
11/18/2024
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