# WOODLAWN HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Hamilton Grove
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730174434
- **Authorized official:** MR. JOHN ALLEY (PRESIDENT/CEO)
- **Authorized official phone:** (574) 223-3141

## Contact information

- **Practice address:** 31869 CHICAGO TRAIL, NEW CARLISLE, IN 46552-9639
- **Practice address phone:** (574) 654-2200
- **Practice address fax:** (574) 654-2219
- **Mailing address:** 31869 CHICAGO TRAIL, NEW CARLISLE, IN 46552-9639
- **Mailing address phone:** (574) 654-2200
- **Mailing address fax:** (574) 654-2219

## Taxonomy

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

## Other

- **Enumeration date:** 09/19/2005
- **Last updated:** 01/28/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100275150A | — | IN |
| 01 | — | 200510580A | MEDICAID WAIVER | IN |
| 01 | — | 7605 | RESIDENTIAL CARE | IN |