- Enrollment id
- O20100121000095
- Enrollment state
- IN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1487649190
- Multiple npi flag
- N
- Ccn
- 155662
- Associate id
- 9739221383
- Organization name
- COMMUNITY VILLAGE INC
- Doing business as name
- REHABILITATION CENTER AT HARTSFIELD VILLAGE
- Incorporation date
- 1995-05-19
- Incorporation state
- IN
- Organization type structure
- OTHER
- Organization other type text
- TAX EXEMPT NOT FOR PROFIT CORPORATION
- Proprietary nonprofit
- N
- Nursing home provider name
- REHABILITATION CENTER AT HARTSFIELD VILLAGE
- Address line 1
- 503 OTIS BOWEN DR
- City
- MUNSTER
- State
- IN
- Zip code
- 463214158