Organization
EXTENDICARE HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL MATTHEWS (PTA)
(812) 739-2292
Entity
Organization
Contact information
Practice address
712 W 2ND ST, LEAVENWORTH, IN 47137-2264
(812) 739-2292
Mailing address
712 W 2ND ST, LEAVENWORTH, IN 47137-2264
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
06004780A
IN
Other
Enumeration date
01/07/2015
Last updated
01/07/2015
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