| NPI | 1497152565 |
|---|---|
| Doing Business As | MEDILODGE OF PORTAGE |
| Entity Type | Organization |
| Authorized Contact | STACEY PAUL ROGERS Chief Financial Officer 502-429-8062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2015-07-17 |