Provider Demographics
NPI:1093742348
Name:FRANCISCAN COMMUNITIES, INC.
Entity Type:Organization
Organization Name:FRANCISCAN COMMUNITIES, INC.
Other - Org Name:GEORGE DAVIS MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP/CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:ZIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-647-6500
Mailing Address - Street 1:1055 175TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-4610
Mailing Address - Country:US
Mailing Address - Phone:708-647-6500
Mailing Address - Fax:708-647-6982
Practice Address - Street 1:1051 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE BRA
Practice Address - State:IN
Practice Address - Zip Code:47906-1447
Practice Address - Country:US
Practice Address - Phone:765-463-2571
Practice Address - Fax:765-463-9401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN SISTERS OF CHICAGO SERVICE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-26
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05-000547-1313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100267440Medicaid