| NPI | 1942641964 |
|---|---|
| Doing Business As | MEDILODGE OF PORT HURON |
| 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 | 2013-07-08 |
| Last Update Date | 2014-12-30 |