Organization
ST JOSEPH HEALTH SYSTEM LLC
Active
Parent organization
ST JOSEPH HEALTH SYSTEM LLC
Other names
St. Joseph Hospital Gero
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST JOSEPH HEALTH SYSTEM LLC
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
700 BROADWAY, FORT WAYNE, IN 46802-1402
(214) 425-3000
(260) 425-3222
Mailing address
PO BOX 15673, CHICAGO, IL 60693-0156
(214) 425-3000
(260) 425-3222
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
1052-0-AFR
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100268500C
—
IN
Enumeration date
05/19/2006
Last updated
04/29/2021
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