Organization
COUNTRY CHARM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. C DIEDERICK VAN DER VELDE (OWNER)
(317) 882-5455
Entity
Organization
Contact information
Practice address
3177 MERIDIAN PARKE DR, GREENWOOD, IN 46142-9629
(317) 882-5455
(317) 882-3606
Mailing address
3177 MERIDIAN PARKE DR, GREENWOOD, IN 46142-9629
(317) 882-5455
(317) 882-3606
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
IN
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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