Organization
RENAISSANCE HEALTH CARE LLC
Active
Other names
Renaissance Village
Organization subpart
No
Provider details
NPI number
Authorized official
DEB I MILLS (ADMINISTRATOR)
(260) 625-3545
Entity
Organization
Contact information
Practice address
6050 S 800 E-92, FORT WAYNE, IN 46814-9201
(260) 625-3545
(260) 625-3328
Mailing address
6050 S 800 E-92, FORT WAYNE, IN 46814-9201
(260) 625-3545
(260) 625-3328
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
050002151
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100267600A
—
IN
Enumeration date
02/03/2006
Last updated
11/18/2011
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