Organization
RIVERVIEW HOSPITAL
Active
Other names
ASHTON CREEK HEALTH AND REHABILITATION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWIGHT A OTT (SECRETARY/TREASURER)
(765) 664-5400
Entity
Organization
Contact information
Practice address
4111 PARK PLACE DRIVE, FORT WAYNE, IN 46845-8793
(765) 664-5400
Mailing address
1800 N WABASH RD, ATTENTION: BETH KLEE, MARION, IN 46952-1300
(765) 664-5400
(765) 664-5403
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201080610
—
IN
Enumeration date
02/03/2012
Last updated
10/06/2014
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