Organization
HP PLEASANT RUN, INC.
Active
Other names
The Manor at Southport
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS K MITTLEIDER (PRESIDENT)
(770) 619-0866
Entity
Organization
Contact information
Practice address
7465 MADISON AVE, INDIANAPOLIS, IN 46227-6564
(317) 787-1108
Mailing address
7465 SOUTH MADISON AVENUE, INDIANAPOLIS, IN 46227
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
IN
Other
Enumeration date
06/18/2007
Last updated
08/22/2020
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