Provider Demographics
NPI:1184872772
Name:BROWN COUNTY HEALTH & LIVING COMMUNITY
Entity type:Organization
Organization Name:BROWN COUNTY HEALTH & LIVING COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-332-2265
Mailing Address - Street 1:55 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47448-7013
Mailing Address - Country:US
Mailing Address - Phone:812-988-6666
Mailing Address - Fax:812-988-6668
Practice Address - Street 1:55 WILLOW ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:IN
Practice Address - Zip Code:47448-7013
Practice Address - Country:US
Practice Address - Phone:812-988-6666
Practice Address - Fax:812-988-6668
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARDON & ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000374A314000000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Multi-Specialty