Provider Demographics
NPI:1114268810
Name:COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL LLC
Entity Type:Organization
Organization Name:COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL LLC
Other - Org Name:COMMUNITY HEALTH NETWORK REHABILITATION HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HOSPITAL CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROXANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:STACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-585-5401
Mailing Address - Street 1:7343 CLEARVISTA DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-4602
Mailing Address - Country:US
Mailing Address - Phone:317-585-5400
Mailing Address - Fax:
Practice Address - Street 1:7343 CLEARVISTA DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256
Practice Address - Country:US
Practice Address - Phone:317-355-5249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital