- Enrollment id
- O20161020002154
- Enrollment state
- IN
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1609819572
- Multiple npi flag
- N
- Ccn
- 155376
- Associate id
- 1557271665
- Organization name
- DAVIESS COUNTY HOSPITAL
- Doing business as name
- MAJESTIC CARE OF SHERIDAN
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- MAJESTIC CARE OF SHERIDAN
- Affiliation entity name
- MAJESTIC CARE
- Affiliation entity id
- 331
- Address line 1
- 803 S HAMILTON ST
- City
- SHERIDAN
- State
- IN
- Zip code
- 460691415