Organization · Type 2 NPI

Hickory Creek Healthcare Foundation, Inc.

Intellectual Disabilities Intermediate Care Facility · Gaston, IN

NPI number 1265463665 Active

Practice location

502 N. Madison St
Gaston, IN 47342-0159

Call (765) 358-3324 Map

Fax (765) 358-4365

Mailing address

6081 E 82nd St, Suite 120
Indianapolis, IN 46250-1795

Specialties and licenses

Taxonomy	Code	License
Intellectual Disabilities Intermediate Care Facility Primary	315P00000X	05-000614-1 (IN)

Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.

NPI record

NPI: 1265463665
Entity type: Organization (Type 2)
Issued: Jul 5, 2006
Last updated: Sep 26, 2013
Status: Active
Subpart: Yes of Hickory Creek Healthcare Foundation Inc

Other names

<unavail>
Hickory Creek at Gaston · doing business as

Authorized official

Mr. Gary Brent Waymire
Vice President of Operations
(317) 570-0266

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1265463665

Hickory Creek Healthcare Foundation, Inc.'s National Provider Identifier is 1265463665, issued on Jul 5, 2006. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Gaston, IN. The record was last updated on Sep 26, 2013.