# THE WATERS OF SCOTTSBURG, LLC

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

## Provider details

- **NPI number:** 1851454573
- **Authorized official:** MR. JERRY V. KEMPER (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (317) 598-9496

## Contact information

- **Practice address:** 1350 N. TODD DRIVE, SCOTTSBURG, IN 47170-7755
- **Practice address phone:** (812) 752-5663
- **Practice address fax:** (812) 752-9853
- **Mailing address:** 9785 CROSSPOINT BLVD., SUITE 104, INDIANAPOLIS, IN 40256-3321
- **Mailing address phone:** (317) 598-9496
- **Mailing address fax:** (317) 598-9467

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 08-000478-1 | IN | — |
| 314000000X | Skilled Nursing Facility | 060004783 | IN | Yes |

## Other

- **Enumeration date:** 12/18/2006
- **Last updated:** 03/23/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100290430 | — | IN |
| 05 | — | 100290430E | — | IN |