# HP PLEASANT RUN, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** The Manor at Southport
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730384009
- **Authorized official:** DOUGLAS K MITTLEIDER (PRESIDENT)
- **Authorized official phone:** (770) 619-0866

## Contact information

- **Practice address:** 7465 MADISON AVE, INDIANAPOLIS, IN 46227-6564
- **Practice address phone:** (317) 787-1108
- **Mailing address:** 7465 SOUTH MADISON AVENUE, INDIANAPOLIS, IN 46227

## Taxonomy

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

## Other

- **Enumeration date:** 06/18/2007
- **Last updated:** 08/22/2020