Waggoner

LBN: Normal Life Of Indiana
Waggoner is an health care organization with primary practice located at 3512 Waggoner Ave , Evansville IN 47714-5463. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Normal Life Of Indiana can be contacted via phone (812) 433-3535, or through Ombres, Deena via phone (502) 394-2387.

Contact Information

Primary practice address
3512 Waggoner Ave Evansville IN 47714-5463
Phone: (812) 433-3535
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ombres, Deena
Phone: (502) 394-2387

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X

Profile Details

NPI number 1689792574
LBN Legal business name Normal Life Of Indiana
DBA Doing business as Waggoner
Authorized official Ombres, Deena
Entity Organization
Organization subpart 1 No
Enumeration date Mar 27th, 2007
Last updated Jul 16th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689792574 NPPES
Indiana MEDICAID 100234400A

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