Organization
INDIANA HEALTH AND REHABILITATION CENTERS
Active
Other names
Canterbury Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA J MAASSEN (PRIVACY OFFICER)
(414) 908-8119
Entity
Organization
Contact information
Practice address
2827 NORTHGATE BLVD, FORT WAYNE, IN 46835-2903
(260) 492-1400
(260) 492-1699
Mailing address
111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
(414) 908-8119
(414) 908-7105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100290930B
—
IN
Enumeration date
08/23/2006
Last updated
12/06/2011
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