NPI 1265419428

Brookside Village, INC

Organisation Skilled Nursing Facility Jasper, IN

Practice location

Address: 1111 Church Ave, Jasper, IN 47546-3761
Phone: (812) 634-7750
Fax: (812) 634-7751
Mailing address: 2749 E Covenanter Dr, Bloomington, IN 47401-5454

Authorised official

Name: Stephen G. Moore
Title: President/Ceo
Phone: (812) 332-2265

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 050032401 (IN)

Other Skilled Nursing Facility providers in Indiana →

Registry record

NPI: 1265419428
Entity type: Organization
NPI issued: 29 Dec 2005
Record last updated: 20 Mar 2017

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.