Organization
WITHAM MEMORIAL HOSPITAL
Active
Other names
Greenleaf Health Campus
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY BRAVERMAN (CEO, PRESIDENT)
(765) 485-8100
Entity
Organization
Contact information
Practice address
1201 E BEARDSLEY AVE, ELKHART, IN 46514-3574
(574) 206-0086
(574) 266-3673
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
—
201056540
—
IN
Enumeration date
04/29/2010
Last updated
03/26/2022
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