The Waters Of Lagrange Skilled Nursing Facility

LBN: Johnson Memorial Hospital
The Waters Of Lagrange Skilled Nursing Facility is an health care organization with primary practice located at 787 N Detroit St , Lagrange IN 46761-1111. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Johnson Memorial Hospital can be contacted via phone (574) 466-2172, or through Dunkle, David via phone (317) 736-3396.

Contact Information

Primary practice address
787 N Detroit St Lagrange IN 46761-1111
Phone: (574) 466-2172
Fax: (574) 463-2180
Website:
Map and Directions
Authorized official contact:
Name: Dunkle, David Doctor of Medicine (MD)
Phone: (317) 736-3396

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 06-000049-1 Indiana
Suppliers / Nursing Facility Supplies 332BN1400X
Suppliers / Parenteral & Enteral Nutrition 332BP3500X Indiana

Profile Details

NPI number 1255352399
LBN Legal business name Johnson Memorial Hospital
DBA Doing business as The Waters Of Lagrange Skilled Nursing Facility
Authorized official Dunkle, David Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 22nd, 2006
Last updated Jan 30th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255352399 NPPES
Indiana MEDICAID 100270890A

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