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HENRY COUNTY MEMORIAL HOSPITAL
NPI 1205441854
Assisted Living Facility in Indianapolis, IN

Active since September 10, 2020CLIA 15D0899939 · Waiver
3530 S SHELBY ST, INDIANAPOLIS, IN 46227(317) 784-3066(317) 781-3037 Get Directions Write a Review

NPPES record last updated: June 25, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 25, 2020, Sep 10, 2020 (2 updates tracked since 2020).

About Henry County Memorial Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HENRY COUNTY MEMORIAL HOSPITAL (NPI 1205441854), doing business as Bethany Village Assisted Living, is a healthcare organization registered as an assisted living facility in Indianapolis, Indiana and active in the NPI registry since September 2020. The organization holds a CLIA Waiver certificate valid through April 11, 2027 and lists Steve Van Camp, Ceo Of Asc, as its authorized official.

NPPES Registry Identity

NPI1205441854
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameHENRY COUNTY MEMORIAL HOSPITAL
Location Address3530 S SHELBY STIndianapolis, IN 46227-3269
Mailing Address3530 Shelby StIndianapolis, IN 46227-3269 · (317) 784-3066 · Fax (317) 781-3037
Phone(317) 784-3066
Fax(317) 781-3037
Organization SubpartNo
Authorized OfficialSteve Van CampCeo Of Asc · (317) 788-2500
Enumeration DateSeptember 10, 2020
Last NPPES UpdateJune 25, 20262 updates tracked since enumeration
NPPES CertifiedJune 25, 2026
✔ NPI 1205441854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
3530 S SHELBY ST, Indianapolis, IN 46227
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Other Names 1

Doing Business AsBethany Village Assisted Living

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D0899939

Henry County Memorial Hospital Dba Bethany Village Assisted Living · Indianapolis, IN
Active · expires Apr 11, 2027
CLIA Number15D0899939
Laboratory TypeAssisted Living Facility
Certificate Effective DateApril 12, 2025
Certificate Expiration DateApril 11, 2027
Laboratory DirectorGary Griffin
Laboratory Phone(317) 784-3066
Laboratory LocationHenry County Memorial Hospital Dba Bethany Village Assisted Living3530 S Shelby St, Indianapolis, IN 46227
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Henry County Memorial Hospital's NPI number?

The NPI number for Henry County Memorial Hospital is 1205441854. It was assigned to this organization in the NPPES registry on September 10, 2020. The provider is doing business as Bethany Village Assisted Living.

Where is Henry County Memorial Hospital located?

Henry County Memorial Hospital is located at 3530 S Shelby St, Indianapolis, IN 46227. The listed phone number is (317) 784-3066.

What is Henry County Memorial Hospital's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Henry County Memorial Hospital hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D0899939) is associated with this NPI, valid through April 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Henry County Memorial Hospital was last updated on June 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.