NPI 1124736996

The Waters of Sullivan Skilled Nursing Facility LLC

Organisation Skilled Nursing Facility Sullivan, IN

Practice location

Address: 505 W Wolfe St, Sullivan, IN 47882-9224
Phone: (812) 268-6361
Mailing address: 240 Fencl Ln, Hillside, IL 60162-2067

Authorised official

Name: Jeffrey Sax
Title: Manager
Phone: (219) 898-5705

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X

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Registry record

NPI: 1124736996
Entity type: Organization
NPI issued: 10 Nov 2022
Record last updated: 10 Nov 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.