ADAMS COUNTY MEMORIAL HOSPITAL
Assisted Living Facility
South Bend, Indiana
Provider NPI: 1609869064
Organization Information:Organization Name: ADAMS COUNTY MEMORIAL HOSPITAL
Practice Location:
3602 S IRONWOOD DR SOUTH BEND, IN 46614 US
Tel: 574-299-2250 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:
3602 S IRONWOOD DR SOUTH BEND, IN 46614 US
Tel: 574-299-2250 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | IN | 060001041 |
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | IN | 060001041 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
100266590A | IN | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin