Organization
NORMAL LIFE OF INDIANA
Active
Other names
EVANS FOXMOOR
Organization subpart
No
Provider details
NPI number
Authorized official
DEENA OMBRES (PRIVACY OFFICER)
(502) 394-2387
Entity
Organization
Contact information
Practice address
4477 FOXMOOR DR, NEWBURGH, IN 47630-2391
(812) 433-3535
Mailing address
10140 LINN STATION RD, LOUISVILLE, KY 40223-3813
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100234360A
—
IN
Enumeration date
03/27/2007
Last updated
09/23/2010
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