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Hickory Creek Healthcare Foundation, Inc.
Intellectual Disabilities Intermediate Care Facility in Gaston, Indiana
NPI 1265463665

Hickory Creek Healthcare Foundation, Inc. is a Intellectual Disabilities Intermediate Care Facility based in Indianapolis, IN. Hickory Creek Healthcare Foundation, Inc. practices in Gaston, IN. The NPI Number for Hickory Creek Healthcare Foundation, Inc. is 1265463665 and holds a License No. 05-000614-1 (Indiana).

The current practice location address for Hickory Creek Healthcare Foundation, Inc. is 502 N. Madison St, Gaston, IN and can be reached out via phone at 765-358-3324 and via fax at 765-358-4365.

Location: 502 N. Madison St, Gaston, IN, 46250-1795
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1265463665
Provider Name
Hickory Creek Healthcare Foundation, Inc.
Credential
Provider Entity Type
Organization
Address
502 N. Madison St, Gaston, IN, 46250-1795
Phone Number
765-358-3324
Fax Number
765-358-4365
Provider Enumeration Date
07/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100272120 05 IN
institution
Provider Business Practice Location Address Details
Address
502 N. Madison St
City
Gaston
State
Indiana
Zip
47342-0159
Phone Number
765-358-3324
Fax Number
765-358-4365
person
Provider Business Mailing Address Details
Address
502 N. Madison St
City
Gaston
State
Indiana
Zip
47342-0159
Phone Number
765-358-3324
Fax Number
765-358-4365
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
05-000614-1 (Indiana)
Definition
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.
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