Organization
WOODLAWN HOSPITAL
Active
Other names
Hamilton Grove
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN ALLEY (PRESIDENT/CEO)
(574) 223-3141
Entity
Organization
Contact information
Practice address
31869 CHICAGO TRAIL, NEW CARLISLE, IN 46552-9639
(574) 654-2200
(574) 654-2219
Mailing address
31869 CHICAGO TRAIL, NEW CARLISLE, IN 46552-9639
(574) 654-2200
(574) 654-2219
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
IN
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
IN
314000000X
Skilled Nursing Facility
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100275150A
—
IN
01
—
200510580A
MEDICAID WAIVER
IN
01
—
7605
RESIDENTIAL CARE
IN
Enumeration date
09/19/2005
Last updated
01/28/2016
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