Provider Demographics
NPI:1790951184
Name:BRAIRWOOD HEALTH AND REHAB CENTER
Entity Type:Organization
Organization Name:BRAIRWOOD HEALTH AND REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PTA
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:KATHERINE
Authorized Official - Last Name:TROYER
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:317-445-2203
Mailing Address - Street 1:3640 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-3569
Mailing Address - Country:US
Mailing Address - Phone:317-920-7888
Mailing Address - Fax:
Practice Address - Street 1:3640 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-3569
Practice Address - Country:US
Practice Address - Phone:317-920-7888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06003667A314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility