Brooke Knoll Village

LBN: Witham Memorial Hospital
Brooke Knoll Village is an health care organization with primary practice located at 1108 Kingwood Drive , Avon IN 46123-5500. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Witham Memorial Hospital can be contacted via phone (317) 204-1100, or through Braverman, Kelly via phone (765) 485-8100.

Contact Information

Primary practice address
1108 Kingwood Drive Avon IN 46123-5500
Phone: (317) 204-1100
Fax: (317) 271-7054
Website:
Map and Directions
Authorized official contact:
Name: Braverman, Kelly
Phone: (765) 485-8100

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 13-012901-1 Indiana
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X

Profile Details

NPI number 1598192957
LBN Legal business name Witham Memorial Hospital
DBA Doing business as Brooke Knoll Village
Authorized official Braverman, Kelly
Entity Organization
Organization subpart 1 No
Enumeration date Oct 1st, 2013
Last updated Jul 2nd, 2024 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598192957 NPPES
Indiana MEDICAID 300023505

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