Organization
MAGNOLIA HEALTH SYSTEMS 49, LLC
Active
Other names
BRECKENRIDGE COMMONS RESIDENTIAL FACILITY
Organization subpart
No
Provider details
NPI number
Authorized official
STUART REED (MEMBER)
(317) 818-1240
Entity
Organization
Contact information
Practice address
2009 N HOSPITAL BLVD, SULLIVAN, IN 47882-7658
(812) 268-2000
(812) 268-2080
Mailing address
8455 KEYSTONE XING, INDIANAPOLIS, IN 46240-4353
(317) 818-1240
(317) 818-0720
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
15-013401-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15-013401-1
INDIANA STATE DEPARTMENT OF HEALTH LICENSE
IN
Enumeration date
11/11/2015
Last updated
07/15/2024
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