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BROOKSIDE VILLAGE, INC

Assisted Living Facility

Jasper, Indiana

Provider NPI: 1265419428

Organization Information:
Organization Name:  BROOKSIDE VILLAGE, INC


Practice Location:
1111 CHURCH AVE  JASPER, IN 47546 US
Tel: 812-634-7750  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y314000000XNursing & Custodial Care Facilities
Skilled Nursing Facility
IN050032401

Other Provider Identifiers:

IssuerNumberStateType
201274720AIN05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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