Organization
FRANCISCAN HEALTH RENSSELAER, INC.
Active
Other names
Franciscan Healthcare Rensselaer
Organization subpart
No
Provider details
NPI number
Authorized official
TERRANCE E WILSON (PRESIDENT & CHIEF EXECUTIVE OFFICER)
(765) 502-4440
Entity
Organization
Contact information
Practice address
1104 E GRACE ST, RENSSELAER, IN 47978-3211
(219) 866-5141
Mailing address
1104 E GRACE ST, RENSSELAER, IN 47978-3211
(219) 866-5141
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
05-005072-2
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100269660A
MEDICAID
IN
Enumeration date
08/19/2015
Last updated
10/17/2016
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