Provider Demographics
NPI:1669608865
Name:INDIANSPRING HEALTH CARE CENTER, LLC
Entity type:Organization
Organization Name:INDIANSPRING HEALTH CARE CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPAULDING
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:513-707-1546
Mailing Address - Street 1:390 WARDS CORNER RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6969
Mailing Address - Country:US
Mailing Address - Phone:513-943-4000
Mailing Address - Fax:513-943-4240
Practice Address - Street 1:4900 BABSON PLACE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227
Practice Address - Country:US
Practice Address - Phone:513-562-2600
Practice Address - Fax:513-562-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2990483Medicaid
OH366380Medicare Oscar/Certification