- Enrollment id
- O20150611002178
- Enrollment state
- IN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1457569915
- Multiple npi flag
- N
- Ccn
- 155508
- Associate id
- 0446167415
- Organization name
- MAJOR HOSPITAL
- Doing business as name
- TRANSCENDENT HEALTHCARE OF BOONVILLE
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- TRANSCENDENT HEALTHCARE OF BOONVILLE
- Address line 1
- 725 S 2ND ST
- City
- BOONVILLE
- State
- IN
- Zip code
- 476011961