Organization
THE WYNDMOOR OF EVANSVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LACHELE RAE HENKLE WEAVER HFA, MBA, CLSS (OWNER/OPERATOR)
(317) 258-7031
Entity
Organization
Contact information
Practice address
6521 GREENDALE DR, EVANSVILLE, IN 47711-1741
(812) 867-7900
Mailing address
6070 HUNTERS RIDGE DR, PLAINFIELD, IN 46168-7919
(317) 258-7031
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19-010681-1
ISDH LICENSED RESIDENTIAL CARE
IN
Enumeration date
08/02/2019
Last updated
08/02/2019
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