Organization
HENDRICKS COUNTY HOSPITAL
Active
Other names
Brickyard Healthcare - Portage Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN P SPEER (PRESIDENT/CEO)
(317) 745-4451
Entity
Organization
Contact information
Practice address
3175 LANCER ST, PORTAGE, IN 46368-4407
(219) 762-9571
Mailing address
3175 LANCER ST, PORTAGE, IN 46368-4407
(219) 762-9571
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100290980
—
IN
Enumeration date
03/07/2008
Last updated
06/14/2022
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