Organization
ELKHART GENERAL HOSPITAL FOUNDATION, INC.
Active
Parent organization
ELKHART GENERAL HOSPITAL, INC.
Other names
Lifeline
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELKHART GENERAL HOSPITAL, INC.
Authorized official
MR. JONATHAN W. HOUSAND JR. (EX. DIRECTOR OF EGH FOUNDATION, INC)
(574) 524-7458
Entity
Organization
Contact information
Practice address
2020 INDUSTRIAL PARKWAY, LIFELINE, ELKHART, IN 46516-5411
(574) 524-7503
(574) 524-7500
Mailing address
600 EAST BLVD, EGH FOUNDATION, INC./LIFELINE, ELKHART, IN 46514-2483
(574) 524-7458
(574) 523-3383
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
11-005017-1
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICAID WAIVER
IN
Enumeration date
10/31/2011
Last updated
10/31/2011
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