HICKORY CREEK HEALTHCARE FOUNDATION, INC. (NPI# 1265463665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265463665 |
| Entity Type | Organization |
| Organization Name | HICKORY CREEK HEALTHCARE FOUNDATION, INC. |
| Other Organization Name | HICKORY CREEK AT GASTON |
| Practice Address |
502 N. Madison St Gaston IN 47342-0159 |
| Mailing Address |
6081 E 82nd St Suite 120 Indianapolis IN 46250-1795 |
| Practice Telephone | 7653583324 |
| Practice Fax Number | 7653584365 |
| Mailing Telephone | 3175700266 |
| Mailing Fax Number | 3175700488 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2013-09-26 |
| Authorized Official Name | MR. GARY BRENT WAYMIRE (VICE PRESIDENT OF OPERATIONS) |
| Authorized Official Telephone | 3175700266 |
| Is Organization Subpart | Y |
| Parent Organization Name | HICKORY CREEK HEALTHCARE FOUNDATION INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 05-000614-1 | IN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 100272120 | 05 |
| Other Name | Type Code |
|---|---|
| Hickory Creek at Gaston | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740214493 | Hickory Creek Healthcare Foundation, Inc. | Skilled Nursing Facility | 1585 Perry Worth Rd, Lebanon, IN 46052-9635 | 2006-07-10 |
| 1679502439 | Hickory Creek Healthcare Foundation, Inc. | Skilled Nursing Facility | 401 Fountain St, Hicksville, OH 43526-1337 | 2006-07-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | HICKORY CREEK HEALTHCARE FOUNDATION, INC. | 5555 Glenridge Connector, Suite 650, Atlanta, GA 30342 |
| Street Address |
502 N. MADISON ST |
| City | GASTON |
| State | IN |
| Zip Code | 47342-0159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801019112 | Gaston Volunteer Fire Dept, Inc | Ambulance | 105 N. Sycamore St, Gaston, IN 47342 | 2007-04-11 |
| 1215016209 | Reva Hodge | Specialist | 12650 W. County Road 1100 N., Gaston, IN 47342 | 2006-11-02 |
| 1457910762 | Gemma E Smith | Speech-Language Pathologist | 3621 W County Road 900 N, Gaston, IN 47342-9014 | 2019-06-10 |
| 1275071391 | Makayla Rose Johnson | Student in an Organized Health Care Education/Training Program | 17001 N Angler Club Rd, Gaston, IN 47342-9225 | 2017-02-09 |
| 1386955367 | Lora Linn Wilson | Physical Therapy Assistant | 8000 N County Road 600 W, Gaston, IN 47342-9339 | 2010-06-24 |
| 1942362306 | Wes-del Community Schools | Local Education Agency (LEA) | 10290 N County Road 600 W, Gaston, IN 47342-9341 | 2006-12-14 |
| 1215198288 | Dawn M Jeffers | Dietitian, Registered | 9811 W Bethel Ave, Gaston, IN 47342-9772 | 2008-06-22 |
| 1538204870 | Dermatology, PC | Dermatology | 330 N Wabash Ave, #360, Marion, IN 47342-9999 | 2007-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245256 | Aloura Linfesty | Dietitian, Registered | 12944 Sw Sara Dr, Gaston, OR 97119-8580 | 2020-11-05 |
| 1760092548 | Stephanie M Torrado | Technician | 344 Lawndale Dr, Gaston, SC 29053-8114 | 2020-08-05 |
| 1225661242 | Patricia Shamberger | Private Vehicle | 127 G and K Ct Apt C, Gaston, SC 29053-9298 | 2020-02-18 |
| 1932739893 | Kristen Leah Mccarter | Behavior Technician | 108 Roundtree Dr, Gaston, SC 29053-8771 | 2020-01-20 |
| 1598315798 | Healthstat Onsite Clinic Zeus Columbia | Preventive Medicine | 115 15th St, Gaston, SC 29053-8260 | 2019-09-19 |
| 1457910762 | Gemma E Smith | Speech-Language Pathologist | 3621 W County Road 900 N, Gaston, IN 47342-9014 | 2019-06-10 |
| 1568945210 | Fresenius Medical Care Cna Kidney Centers, LLC | Clinic/Center | 5301 Highway 321, Gaston, SC 29053-9196 | 2018-09-10 |
| 1760989537 | Joanna Wallace | Early Intervention Provider Agency | 241 Woodcote Dr, Gaston, SC 29053-8479 | 2018-04-09 |
| 1982143848 | Southern Support | Community/Behavioral Health | 480 River Rd, Gaston, NC 27832-9079 | 2017-02-13 |
| 1275071391 | Makayla Rose Johnson | Student in an Organized Health Care Education/Training Program | 17001 N Angler Club Rd, Gaston, IN 47342-9225 | 2017-02-09 |
| Find all providers in GASTON | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (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. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689051757 | The Arc of Northeast Indiana, Inc. | Intermediate Care Facility, Mentally Retarded | 4720 Ashland Dr, Fort Wayne, IN 46835-1510 | 2015-04-28 |
| 1710251830 | Rescare Inc. | Intermediate Care Facility, Mentally Retarded | 213 W. Water St., Centerville, IN 47330 | 2012-03-07 |
| 1871866368 | Rescare Inc. | Intermediate Care Facility, Mentally Retarded | 1010 Kellam Road, Centerville, IN 47330 | 2012-02-15 |
| 1215237672 | Pathfinder Services, Inc. | Intermediate Care Facility, Mentally Retarded | 2038 Camden Ct, Huntington, IN 46750-3993 | 2010-11-01 |
| 1396050076 | Pathfinder Services Inc | Intermediate Care Facility, Mentally Retarded | 2033 Duncan Dr, Huntington, IN 46750-4501 | 2010-08-18 |
| 1003052184 | Rescare, Inc. | Intermediate Care Facility, Mentally Retarded | 16609 Sima Gray Rd, Henryville, IN 47126-8626 | 2008-12-19 |
| 1912143009 | Rescare, Inc. | Intermediate Care Facility, Mentally Retarded | 16611 Sima Gray Rd, Henryville, IN 47126-8626 | 2008-12-19 |
| 1649416736 | Rescare, Inc. | Intermediate Care Facility, Mentally Retarded | 16613 Sima Gray Rd, Henryville, IN 47126-8626 | 2008-12-19 |
| 1528213360 | Res-care, Inc. | Intermediate Care Facility, Mentally Retarded | 1306 S Bloomington St, Greencastle, IN 46135-2208 | 2008-11-20 |
| 1316194863 | The Arc of Northeast Indiana, Inc | Intermediate Care Facility, Mentally Retarded | 4915 Haffner Drive, Fort Wayne, IN 46825-3535 | 2008-08-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.