Organization
WITHAM MEMORIAL HOSPITAL
Active
Other names
Wellbrooke of Wabash
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BRAVERMAN (CEO, PRESIDENT)
(765) 485-8100
Entity
Organization
Contact information
Practice address
20 JOHN KISSINGER DR, WABASH, IN 46992
(260) 274-0444
(260) 274-0181
Mailing address
PO BOX 221648, LOUISVILLE, KY 40252-1648
(502) 412-5847
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201208210
—
IN
Enumeration date
11/21/2012
Last updated
03/26/2022
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