Organization
HOOSIER ENTERPRISES II, INC.
Active
Other names
ESPECIALLY KIDZ HEALTH & REHAB CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND INGHAM PH.D. (PRESIDENT, CEO)
(765) 485-8100
Entity
Organization
Contact information
Practice address
2325 S MILLER ST, SHELBYVILLE, IN 46176-9350
(317) 392-3287
(317) 398-9707
Mailing address
9480 PRIORITY WAY WEST DR, INDIANAPOLIS, IN 46240-1470
(317) 811-8124
(317) 818-1022
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
10 000273 1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100267870C
—
IN
Enumeration date
11/30/2006
Last updated
07/23/2012
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