Organization
THE WYNDMOOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN G. MOORE MD (PRESIDENT)
(812) 332-2265
Entity
Organization
Contact information
Practice address
1465 E CROSSING BLVD, TERRE HAUTE, IN 47802-5315
(812) 298-9963
(812) 299-0660
Mailing address
2749 E COVENANTER DR, BLOOMINGTON, IN 47401-5454
(812) 332-2265
(812) 334-0853
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
IN00000
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IN0000
ASSISTED LIVING FACILITY
IN
Enumeration date
07/16/2006
Last updated
08/22/2020
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