Active NPI
Elkhart General Hospital Foundation, Inc.
- In Home Supportive Care Agency
- Elkhart, IN
National Provider Identifier
1750667184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 11-005017-1
- Legal business name
- ELKHART GENERAL HOSPITAL FOUNDATION, INC.
- Doing business as
- Lifeline
- Practice address
- 2020 Industrial Parkway
Lifeline
Elkhart, IN 46516-5411 - Phone
- (574) 524-7503
- Fax
- (574) 524-7500
- NPI assigned
- Oct 31, 2011
- Organization subpart
- Yes
- Parent organization
- ELKHART GENERAL HOSPITAL, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jonathan W. Housand Jr.
- Title
- Ex. Director of Egh Foundation, Inc
- Phone
- (574) 524-7458
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 11-005017-1 | IN | Primary |
Addresses
Primary practice location
2020 Industrial Parkway
Lifeline
Elkhart, IN 46516-5411
Mailing address
600 East Blvd
Egh Foundation, Inc./Lifeline
Elkhart, IN 46514-2483
Phone (574) 524-7458
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Other | IN | MEDICAID WAIVER |
Other names 1
- Lifeline
National Provider Directory
National Provider Directory- Part of
- Elkhart General Hos Osc
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1320019200000",
"number": "1750667184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 EAST BLVD",
"address_2": "EGH FOUNDATION, INC./LIFELINE",
"city": "ELKHART",
"state": "IN",
"postal_code": "465142483",
"telephone_number": "574-524-7458",
"fax_number": "574-523-3383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 INDUSTRIAL PARKWAY",
"address_2": "LIFELINE",
"city": "ELKHART",
"state": "IN",
"postal_code": "465165411",
"telephone_number": "574-524-7503",
"fax_number": "574-524-7500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELKHART GENERAL HOSPITAL FOUNDATION, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ELKHART GENERAL HOSPITAL, INC.",
"enumeration_date": "2011-10-31",
"last_updated": "2011-10-31",
"status": "A",
"authorized_official_last_name": "HOUSAND",
"authorized_official_first_name": "JONATHAN",
"authorized_official_middle_name": "W.",
"authorized_official_title_or_position": "EX. DIRECTOR OF EGH FOUNDATION, INC",
"authorized_official_telephone_number": "574-524-7458",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "IN",
"license": "11-005017-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID WAIVER",
"identifier": "PENDING",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lifeline",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.