Organization
PULASKI MEMORIAL HOSPITAL
Active
Other names
Northern Lakes Nursing & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BAKER (CORP OPERATIONS MANAGER)
(812) 748-9155
Entity
Organization
Contact information
Practice address
516 WILLIAMS ST, ANGOLA, IN 46703-1144
(260) 665-9467
(260) 624-2297
Mailing address
516 WILLIAMS ST, ANGOLA, IN 46703-1144
(260) 665-9467
(260) 624-2297
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
050004261
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100275480
—
IN
Enumeration date
11/03/2005
Last updated
02/26/2018
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