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ST PAUL HERMITAGE HOME

Nursing/Intermediate Care Facility

Beech Grove, Indiana

Provider NPI: 1871605055

Organization Information:
Organization Name:  ST PAUL HERMITAGE HOME


Practice Location:
501 N 17TH AVENUE  BEECH GROVE, IN 46107 US
Tel: 317-786-2261  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y313M00000XNursing & Custodial Care Facilities
Nursing Facility/Intermediate Care Facility
IN060003911

Other Provider Identifiers:

IssuerNumberStateType
100274990AIN05
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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