Organization
KINGSWAY COMMUNITY CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MOLLAUN P (EXECUTIVE DIRECTOR)
(317) 272-0708
Entity
Organization
Contact information
Practice address
6722 E US HIGHWAY 36, AVON, IN 46123-8921
(317) 272-0708
(317) 272-0918
Mailing address
6722 E US HIGHWAY 36, AVON, IN 46123-8921
(317) 272-0708
(317) 272-0918
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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