Organization
ADAMS COUNTY MEMORIAL HOSPITAL
Active
Parent organization
ADAMS COUNTY MEMORIAL HOSPITAL
Other names
Lutheran Life Villages (Anthony)
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADAMS COUNTY MEMORIAL HOSPITAL
Authorized official
MR. DANE WHEELER CPA (CFO/TREASURER)
(260) 724-2145
Entity
Organization
Contact information
Practice address
6701 SOUTH ANTHONY BOULEVARD, FORT WAYNE, IN 46816-2035
(260) 447-0800
(260) 447-7369
Mailing address
1100 MERCER AVE, DECATUR, IN 46733-2303
(260) 724-2145
(260) 728-3852
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
050002831
IN
314000000X
Skilled Nursing Facility
Primary
050002831
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0220
RCAP
—
05
—
100275020
—
IN
05
—
201235720A
—
IN
Enumeration date
06/09/2006
Last updated
09/29/2014
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