- Enrollment id
- O20130912000154
- Enrollment state
- IN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1003853557
- Multiple npi flag
- N
- Ccn
- 155443
- Associate id
- 6002724085
- Organization name
- HENRY COUNTY MEMORIAL HOSPITAL
- Doing business as name
- THE WATERS OF MUNCIE
- Organization type structure
- OTHER
- Organization other type text
- INDIANA COUNTY HOSPITAL
- Proprietary nonprofit
- N
- Nursing home provider name
- WATERS OF MUNCIE, THE
- Affiliation entity name
- INFINITY HEALTHCARE CONSULTING
- Affiliation entity id
- 763
- Address line 1
- 2400 CHATEAU DR
- City
- MUNCIE
- State
- IN
- Zip code
- 473031900