Organization
GAHC3 ELKHART IN ALF TRS SUB, LLC
Active
Other names
Eastlake Terrace
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY PROSKY (AUTHORIZED REPRESENTATIVE)
(949) 270-9200
Entity
Organization
Contact information
Practice address
3109 E BRISTOL ST, ELKHART, IN 46514-4372
(317) 324-9562
Mailing address
3109 E BRISTOL ST, ELKHART, IN 46514-4372
(317) 324-9562
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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