Organization
WITHAM MEMORIAL HOSPITAL
Active
Other names
WILLOW CROSSING HEALTH AND REHABILITATION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BRAVERMAN (CEO, PRESIDENT)
(765) 481-8100
Entity
Organization
Contact information
Practice address
3550 CENTRAL AVE, COLUMBUS, IN 47203-2035
(812) 379-9669
(812) 378-5248
Mailing address
9480 PRIORITY WAY WEST DR, INDIANAPOLIS, IN 46240-1470
(317) 818-1240
(317) 818-1022
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
11-000572-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100267710
—
IN
Enumeration date
01/11/2008
Last updated
06/24/2022
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