Organization
HENDRICKS COUNTY HOSPITAL
Active
Other names
Life Care Center of Fort Wayne
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY CROSS (ASSIST SECRETARY)
(423) 473-5867
Entity
Organization
Contact information
Practice address
1649 SPY RUN AVE, FORT WAYNE, IN 46805-4032
(260) 422-8520
(260) 422-9345
Mailing address
3001 KEITH ST NW, CLEVELAND, TN 37312-3713
(423) 473-5751
(423) 339-8342
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05000167
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100273740
—
IN
Enumeration date
05/27/2006
Last updated
04/09/2019
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