White River Lodge, Ltd

LBN: White River Lodge, Ltd
White River Lodge, Ltd is an health care organization with primary practice located at 3710 Kenny Simpson Ln , Bedford IN 47421-5632. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. White River Lodge, Ltd can be contacted via phone (812) 275-7006, or through Premo, Brenda via phone (812) 275-7006.

Contact Information

Primary practice address
3710 Kenny Simpson Ln Bedford IN 47421-5632
Phone: (812) 275-7006
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Premo, Brenda
Phone: (812) 275-7006

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 4843 Indiana

Profile Details

NPI number 1922218031
LBN Legal business name White River Lodge, Ltd
DBA Doing business as
Authorized official Premo, Brenda
Entity Organization
Organization subpart 1 No
Enumeration date May 23rd, 2007
Last updated Jan 6th, 2012 - about 12 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 1922218031 NPPES
Indiana MEDICAID 200155900A

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