# EXTENDICARE HEALTH FACILITIES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Michiana Health and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932427309
- **Authorized official:** MS. DONNA J MAASSEN (DIRECTOR OF COMPLIANCE)
- **Authorized official phone:** (414) 908-8119

## Contact information

- **Practice address:** 1420 E DOUGLAS ROAD, MISHAWAKA, IN 46545-1733
- **Practice address phone:** (502) 216-6344
- **Mailing address:** 111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
- **Mailing address phone:** (414) 908-8119
- **Mailing address fax:** (414) 908-7105

## Taxonomy

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

## Other

- **Enumeration date:** 05/11/2010
- **Last updated:** 04/28/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 201002500 | — | IN |