Organization
MAJOR HOSPITAL
Active
Other names
The Waters of Clifty Falls
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HORNER (PRESIDENT & CEO)
(317) 398-5252
Entity
Organization
Contact information
Practice address
950 CROSS AVE, MADISON, IN 47250-2002
(812) 273-4640
(812) 273-2925
Mailing address
950 CROSS AVE, MADISON, IN 47250-2002
(812) 273-4640
(812) 273-2925
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05-000116-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000380292
ANTHEM BCBS
IN
01
—
000000384632
ANTHEM BCBS OT OUTPATIENT
IN
01
—
000000384633
ANTHEM BCBS ST OUTPATIENT
IN
01
—
000000384634
ANTHEM BCBS PT OUTPATIENT
IN
05
—
100266330C
—
IN
Enumeration date
06/02/2006
Last updated
08/07/2014
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