Provider Demographics
NPI:1700820149
Name:NORTON - KINGS DAUGHTERS HEALTH INC
Entity Type:Organization
Organization Name:NORTON - KINGS DAUGHTERS HEALTH INC
Other - Org Name:THE BETHANY CIRCLE OF KING'S DAUGHTERS' HEALTH OF MADISON INDIANA, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-801-0105
Mailing Address - Street 1:PO BOX 3285
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47732-3285
Mailing Address - Country:US
Mailing Address - Phone:812-801-0715
Mailing Address - Fax:812-265-6603
Practice Address - Street 1:2670 MICHIGAN RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-1832
Practice Address - Country:US
Practice Address - Phone:812-801-0671
Practice Address - Fax:812-273-6797
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTON - KINGS DAUGHTERS HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-15
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200010440AMedicaid
IN200010440AMedicaid