| NPI | 1649855917 |
|---|---|
| Doing Business As | MEDILODGE OF SOUTH HAVEN |
| Entity Type | Organization |
| Authorized Contact | JONATHAN OHLSEN Chief Legal Officer 541-543-1215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2021-03-17 |
| Last Update Date | 2021-03-17 |