Organization
MCCARROLL MANAGEMENT CORPORATION
Active
Other names
Westpark Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID L MCCARROLL (PRESIDENT)
(317) 634-8330
Entity
Organization
Contact information
Practice address
1316 N TIBBS AVE, INDIANAPOLIS, IN 46222-3024
(317) 634-8330
(317) 263-9442
Mailing address
1316 N TIBBS AVE, INDIANAPOLIS, IN 46222-3024
(317) 634-8330
(317) 263-9442
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
050004731
IN
314000000X
Skilled Nursing Facility
05004731
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000097937
ANTHEM BCBS
IN
05
—
100290410B
—
IN
Enumeration date
06/20/2005
Last updated
10/30/2012
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