Organization
WOODLAWN HOSPITAL
Active
Other names
Golden Years Homestead
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ALLEY (PRESIDENT/CEO)
(574) 223-3141
Entity
Organization
Contact information
Practice address
3136 GOEGLEIN RD, FORT WAYNE, IN 46815-6685
(260) 749-9655
(260) 749-9656
Mailing address
3136 GOEGLEIN RD, FORT WAYNE, IN 46815-6685
(260) 749-9655
(260) 749-9656
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
05-000282
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0501560M
—
IN
Enumeration date
02/13/2007
Last updated
01/07/2019
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