- Enrollment id
- O20140804000938
- Enrollment state
- IN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1356389902
- Multiple npi flag
- N
- Ccn
- 155409
- Associate id
- 0446167415
- Organization name
- MAJOR HOSPITAL
- Doing business as name
- THE WATERS OF INDIANAPOLIS
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- WATERS OF INDIANAPOLIS, THE
- Affiliation entity name
- INFINITY HEALTHCARE CONSULTING
- Affiliation entity id
- 763
- Address line 1
- 3895 S KEYSTONE AVE
- City
- INDIANAPOLIS
- State
- IN
- Zip code
- 462273540