Hickory Creek Healthcare Foundation, Inc.

NPI #1265463665 in Gaston, Indiana

Provider Information

NPI Number
1265463665
Entity Type
Organization
Organization Name
Hickory Creek Healthcare Foundation, Inc.
Subpart
Yes (part of a larger organization)
Parent Organization
HICKORY CREEK HEALTHCARE FOUNDATION INC
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Jul 5, 2006
Last Updated
Sep 26, 2013

Practice Location

Address
502 N. MADISON ST
City
Gaston
State
Indiana
ZIP Code
47342-0159
Phone
(765) 358-3324

Authorized Official

Name
MR. GARY BRENT WAYMIRE
Title
VICE PRESIDENT OF OPERATIONS
Phone
(317) 570-0266

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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