DECATUR COUNTY MEMORIAL HOSPITAL
Alzheimer Center
South Bend, Indiana
Provider NPI: 1164599304
Organization Information:Organization Name: DECATUR COUNTY MEMORIAL HOSPITAL
Practice Location:
18325 BAILEY AVE SOUTH BEND, IN 46637 US
Tel: 574-272-2602 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
18325 BAILEY AVE SOUTH BEND, IN 46637 US
Tel: 574-272-2602 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | IN | 11-004732-1 |
N | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | IN | 14003759 |
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | IN | 15-0047321-1 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
200808300A | IN | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin