Provider Demographics
NPI:1043295702
Name:HILDEGARD HEALTH CENTER,INC.
Entity Type:Organization
Organization Name:HILDEGARD HEALTH CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-367-1411
Mailing Address - Street 1:802 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:FERDINAND
Mailing Address - State:IN
Mailing Address - Zip Code:47532-9239
Mailing Address - Country:US
Mailing Address - Phone:812-367-1411
Mailing Address - Fax:812-367-1309
Practice Address - Street 1:802 E 10TH ST
Practice Address - Street 2:
Practice Address - City:FERDINAND
Practice Address - State:IN
Practice Address - Zip Code:47532-9239
Practice Address - Country:US
Practice Address - Phone:812-367-1411
Practice Address - Fax:812-367-1309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05-004429-1313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility