Provider Demographics
NPI:1568404226
Name:WINDROSE HEALTH NETWORK, INC.
Entity Type:Organization
Organization Name:WINDROSE HEALTH NETWORK, INC.
Other - Org Name:EDINBURGH/TRAFALGAR FAMILY HEALTH CENTERS, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:KOLENDA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:317-878-2301
Mailing Address - Street 1:14 TRAFALGAR SQ
Mailing Address - Street 2:
Mailing Address - City:TRAFALGAR
Mailing Address - State:IN
Mailing Address - Zip Code:46181-9515
Mailing Address - Country:US
Mailing Address - Phone:317-878-2301
Mailing Address - Fax:317-878-2302
Practice Address - Street 1:14 TRAFALGAR SQ
Practice Address - Street 2:
Practice Address - City:TRAFALGAR
Practice Address - State:IN
Practice Address - Zip Code:46181-9515
Practice Address - Country:US
Practice Address - Phone:317-878-2301
Practice Address - Fax:317-878-2302
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WINDROSE HEALTH NETWORK, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-10
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200127470Medicaid
IN200127470Medicaid
IN151828Medicare Oscar/Certification
IN151844Medicare Oscar/Certification
IN181855Medicare Oscar/Certification