# DYCORA TRANSITIONAL HEALTH - BLOOMINGTON LLC

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

## Provider details

- **NPI number:** 1578006557
- **Authorized official:** MARY HAWKINS (EXECUTIVE)
- **Authorized official phone:** (812) 332-4437

## Contact information

- **Practice address:** 155 E BURKS DR, BLOOMINGTON, IN 47401-8459
- **Practice address phone:** (812) 332-4437
- **Mailing address:** 155 E BURKS DR, BLOOMINGTON, IN 47401-8459
- **Mailing address phone:** (812) 332-4437

## Taxonomy

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

## Other

- **Enumeration date:** 11/23/2016
- **Last updated:** 01/24/2018