- Enrollment id
- O20140916000416
- Enrollment state
- IN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1336289867
- Multiple npi flag
- N
- Ccn
- 155295
- Associate id
- 6002724085
- Organization name
- HENRY COUNTY MEMORIAL HOSPITAL
- Doing business as name
- CLINTON HOUSE REHABILITATION AND HEALTHCARE CENTER
- Organization type structure
- OTHER
- Organization other type text
- INDIANA COUNTY HOSPITAL
- Proprietary nonprofit
- N
- Nursing home provider name
- CLINTON HOUSE REHABILITATION AND HEALTHCARE CENTER
- Affiliation entity name
- CASTLE HEALTHCARE
- Affiliation entity id
- 121
- Address line 1
- 809 W FREEMAN ST
- City
- FRANKFORT
- State
- IN
- Zip code
- 460412944