Provider Demographics
NPI:1124239132
Name:GENERAL HEALTHCARE RESOURCES
Entity type:Organization
Organization Name:GENERAL HEALTHCARE RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSING ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-541-1882
Mailing Address - Street 1:6515 E 52ND PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-1715
Mailing Address - Country:US
Mailing Address - Phone:317-541-1882
Mailing Address - Fax:317-541-1874
Practice Address - Street 1:8060 KNUE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1976
Practice Address - Country:US
Practice Address - Phone:317-842-7435
Practice Address - Fax:317-842-7674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN48-03-04-00326251E00000X
282N00000X, 310400000X
IN48-01-02-02913314000000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered251E00000XAgenciesHome Health
Not Answered282N00000XHospitalsGeneral Acute Care Hospital
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Not Answered376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty