1942386263 NPI number — GRANDVIEW CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942386263 NPI number — GRANDVIEW CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GRANDVIEW CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BRIDGEPOINTE HEALTH CAMPUS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942386263
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1900 COLLEGE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VINCENNES
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47591-5663
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-886-9870
Provider Business Mailing Address Fax Number:
812-886-9871

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 COLLEGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VINCENNES
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47591-5663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-886-9870
Provider Business Practice Location Address Fax Number:
812-886-9871
Provider Enumeration Date:
10/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
THOMAS
Authorized Official First Name:
JO
Authorized Official Middle Name:
A
Authorized Official Title or Position:
A/R MANAGER
Authorized Official Telephone Number:
502-213-1720

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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