Provider Demographics
NPI:1467600668
Name:HENDRICKS COUNTY HOSPITAL
Entity Type:Organization
Organization Name:HENDRICKS COUNTY HOSPITAL
Other - Org Name:MANORCARE ASSISTED LIVING AT SUMMER TRACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-745-8352
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-2615
Mailing Address - Country:US
Mailing Address - Phone:419-252-5500
Mailing Address - Fax:877-385-9446
Practice Address - Street 1:12999 N PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5477
Practice Address - Country:US
Practice Address - Phone:317-848-2448
Practice Address - Fax:317-848-1535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2017-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility