Provider Demographics
NPI:1598788853
Name:VAN NESS SPAUGH SMITH INC
Entity Type:Organization
Organization Name:VAN NESS SPAUGH SMITH INC
Other - Org Name:HARBOUR MANOR CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:JAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-649-4558
Mailing Address - Street 1:1667 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-8723
Mailing Address - Country:US
Mailing Address - Phone:317-773-9205
Mailing Address - Fax:765-641-1229
Practice Address - Street 1:1667 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-8723
Practice Address - Country:US
Practice Address - Phone:317-773-9205
Practice Address - Fax:765-641-1229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000097956OtherBLUE CROSS
IN000000097956OtherBLUE CROSS