Organization
BROOKSIDE VILLAGE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN G. MOORE MD (PRESIDENT/CEO)
(812) 332-2265
Entity
Organization
Contact information
Practice address
1111 CHURCH AVE, JASPER, IN 47546-3761
(812) 634-7750
(812) 634-7751
Mailing address
2749 E COVENANTER DR, BLOOMINGTON, IN 47401-5454
(812) 332-2265
(812) 334-0853
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
050032401
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201274720A
—
IN
Enumeration date
12/29/2005
Last updated
03/20/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us