Organization
WITHAM MEMORIAL HOSPITAL
Active
Other names
PERSIMMON RIDGE REHABILITATION CENTRE
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BRAVERMAN (CEO, PRESIDENT)
(765) 485-8100
Entity
Organization
Contact information
Practice address
200 N PARK ST, PORTLAND, IN 47371-1249
(260) 726-9355
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
11-000148-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100275500
—
IN
Enumeration date
07/11/2007
Last updated
06/24/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us