HICKORY CREEK HEALTHCARE FOUNDATION INC. NPI 1265463665

NPI Information

NPI: 1265463665
Provider Name: HICKORY CREEK HEALTHCARE FOUNDATION, INC.

Doing Business As: HICKORY CREEK AT GASTON

Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
502 N. MADISON ST
GASTON, IN
ZIP 47342
Phone: (765) 358-3324
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HICKORY CREEK HEALTHCARE FOUNDATION, INC. is an intermediate care facility mentally retarded in Gaston, IN. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. HICKORY CREEK HEALTHCARE FOUNDATION, INC. NPI is 1265463665. The provider is registered as an organization entity type.
The provider Is Doing Business As Hickory Creek At Gaston.

The provider's business location address is:

502 N. MADISON ST
GASTON, IN
ZIP 47342-159
Phone: (765) 358-3324
Fax: (765) 358-4365

The provider's authorized official is Gary Brent Waymire .
The authorized official title is Vice President Of Operations and has the following contact phone number (317) 570-0266.

The enumeration date for this NPI number is 7/5/2006 and was last updated on 9/26/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities		05-000614-1	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100272120	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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