Provider Demographics
NPI:1720076128
Name:ALLISON HEALTHCARE CORP
Entity Type:Organization
Organization Name:ALLISON HEALTHCARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-874-2814
Mailing Address - Street 1:181 S LOCUST ST POB 549
Mailing Address - Street 2:P. O. BOX 549
Mailing Address - City:POSEYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47633-0549
Mailing Address - Country:US
Mailing Address - Phone:812-874-2814
Mailing Address - Fax:812-874-3369
Practice Address - Street 1:181 S LOCUST ST
Practice Address - Street 2:
Practice Address - City:POSEYVILLE
Practice Address - State:IN
Practice Address - Zip Code:47633-8600
Practice Address - Country:US
Practice Address - Phone:812-874-2814
Practice Address - Fax:812-874-3369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
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
IN155663Medicare Oscar/Certification