# HENDRICKS COUNTY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brickyard Healthcare - Twelfth Street Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851579486
- **Authorized official:** KEVIN P SPEER (PRESIDENT/CEO)
- **Authorized official phone:** (317) 745-4451

## Contact information

- **Practice address:** 811 E 12TH ST, MISHAWAKA, IN 46544-5408
- **Practice address phone:** (574) 259-1917
- **Mailing address:** 811 E 12TH ST, MISHAWAKA, IN 46544-5408

## Taxonomy

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

## Other

- **Enumeration date:** 02/06/2008
- **Last updated:** 06/14/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100291400 | — | IN |