Organization
CHRISTOLE, INC
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
1701 WINSLOW DRIVE, BLOOMINGTON, IN 47404
(812) 336-4711
(812) 336-4781
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
2510S0011DE05
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2510S0011DE05
—
IN
Enumeration date
10/03/2006
Last updated
08/22/2020
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