# MERCY LONG TERM CARE INITIATIVES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Retirement Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992792303
- **Authorized official:** MR. WILLIAM ROBERT LEE CPA (CFO)
- **Authorized official phone:** (812) 945-5221

## Contact information

- **Practice address:** 4915 CHARLESTOWN RD, NEW ALBANY, IN 47150-9426
- **Practice address phone:** (812) 945-5221
- **Practice address fax:** (812) 945-2614
- **Mailing address:** 4915 CHARLESTOWN RD, NEW ALBANY, IN 47150-9426
- **Mailing address phone:** (812) 945-5221
- **Mailing address fax:** (812) 945-2614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | IN | Yes |

## Other

- **Enumeration date:** 09/30/2005
- **Last updated:** 08/22/2020