AMBASSADOR HEALTHCARE, LLC
NPI 1356336861
Skilled Nursing Facility in Centerville, IN

Active since September 12, 2005CLIA 15D0688105 · Waiver
705 E MAIN ST, CENTERVILLE, IN 47330(765) 855-3424(765) 855-1087 Get Directions Write a Review

NPPES record last updated: December 1, 2009. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Ambassador Healthcare, Llc NPPES

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

AMBASSADOR HEALTHCARE, LLC (NPI 1356336861) is a healthcare organization registered as a skilled nursing facility in Centerville, Indiana and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists K. Douglas Cook, Member, as its authorized official.

NPPES Registry Identity

NPI1356336861
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameAMBASSADOR HEALTHCARE, LLC
Location Address705 E MAIN STCenterville, IN 47330-9676
Mailing Address12953 Publishers Dr, Suite 200Fishers, IN 46038-8811 · (317) 577-2827 · Fax (317) 577-5933
Fax(765) 855-1087
Organization SubpartNo
Authorized OfficialK. Douglas CookMember · (317) 577-4150
Enumeration DateSeptember 12, 2005
Last NPPES UpdateDecember 1, 2009
NPI 1356336861 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in IN · 050004561
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
705 E MAIN ST, Centerville, IN 47330

Other Identifiers 3

Medicare ID-Type Unspecified15-5490IN
Other000000315404IN · Bc/bs Provider Number
Medicare ID-Type Unspecified100288750BIN

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 15D0688105

Ambassador Healthcare · Centerville, IN
Active · expires Aug 31, 2026
CLIA Number15D0688105
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDawn Imel
Laboratory Phone(765) 855-3424
Laboratory LocationAmbassador Healthcare705 E Main St, Centerville, IN 47330
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
705 E MAIN ST
CENTERVILLE, IN 47330
Clinical Nurse Specialist (Long-Term Care)
705 E MAIN ST
CENTERVILLE, IN 47330
Skilled Nursing Facility
705 E MAIN ST
CENTERVILLE, IN 47330

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 Ambassador Healthcare, LLC's NPI number?

The NPI number for Ambassador Healthcare, LLC is 1356336861. It was assigned to this organization in the NPPES registry on September 12, 2005.

Where is Ambassador Healthcare, LLC located?

Ambassador Healthcare, LLC is located at 705 E Main St, Centerville, IN 47330. The listed phone number is (765) 855-3424.

What is Ambassador Healthcare, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Ambassador Healthcare, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D0688105) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ambassador Healthcare, LLC was last updated on December 1, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years 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.