Organization
CHRISTOLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT B CLEMONS (C E O)
(812) 988-1257
Entity
Organization
Contact information
Practice address
6630 RHINESTONE DRIVE, ELLETTSVILLE, IN 47492
(812) 876-6682
(812) 876-6782
Mailing address
200 HAWTHORNE, NASHVILLE, IN 47448
(812) 988-1257
(812) 988-1736
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2510S0013DE06
IN
Other
Enumeration date
10/04/2006
Last updated
08/22/2020
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