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COVENANT CARE WALDRON HOME, LLC

Skilled Nursing Facility

Waldron, Indiana

Provider NPI: 1407847361

Organization Information:
Organization Name:  COVENANT CARE WALDRON HOME, LLC


Practice Location:
505 N MAIN ST  WALDRON, IN 46182 US
Tel: 765-525-4371  Fax: --

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


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y314000000XNursing & Custodial Care Facilities
Skilled Nursing Facility
IN050004231

Other Provider Identifiers:

IssuerNumberStateType
100290450AIN05
15570406
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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