# WOODLAWN HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grace Village Health Care Facility
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285723734
- **Authorized official:** JOHN ALLEY (PRESIDENT/CEO)
- **Authorized official phone:** (574) 223-3141

## Contact information

- **Practice address:** 337 GRACE VILLAGE DR, WINONA LAKE, IN 46590-5774
- **Practice address phone:** (574) 372-6200
- **Practice address fax:** (574) 372-6386
- **Mailing address:** 337 GRACE VILLAGE DR, WINONA LAKE, IN 46590-5774
- **Mailing address phone:** (574) 372-6200
- **Mailing address fax:** (574) 372-6386

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 060005011 | IN | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 060005011 | IN | Yes |
| 314000000X | Skilled Nursing Facility | 060005011 | IN | — |

## Other

- **Enumeration date:** 10/12/2006
- **Last updated:** 11/25/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000097895 | ANTHEM PIN NUMBER | IN |
| 05 | — | 100266260A | — | IN |
| 01 | — | 2297 | RBA HOME NUMBER | IN |