Organization
DAVIESS COUNTY HOSPITAL
Active
Other names
LAURELS OF DEKALB
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANIS KHAN (CFO)
(614) 794-8800
Entity
Organization
Contact information
Practice address
520 W LIBERTY ST, BUTLER, IN 46721-1063
(614) 794-8800
(614) 794-8826
Mailing address
520 W LIBERTY ST, BUTLER, IN 46721-1063
(614) 794-8800
(614) 794-8826
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
0005741
IN
314000000X
Skilled Nursing Facility
Primary
0005741
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100266430A
—
IN
01
—
313673677-001
BLUE CROSS BLUE SHIELD #
IN
Enumeration date
05/24/2006
Last updated
01/02/2021
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