Provider Demographics
NPI:1194864843
Name:WELLSTONE REGIONAL HOSPITAL ACQUISITION LLC
Entity Type:Organization
Organization Name:WELLSTONE REGIONAL HOSPITAL ACQUISITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-258-1044
Mailing Address - Street 1:2700 VISSING PARK RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-5943
Mailing Address - Country:US
Mailing Address - Phone:812-284-8000
Mailing Address - Fax:812-258-2023
Practice Address - Street 1:2700 VISSING PARK RD
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-5943
Practice Address - Country:US
Practice Address - Phone:812-284-8000
Practice Address - Fax:812-258-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200820740Medicaid
KY65945685Medicaid
250600Medicare PIN
212540Medicare PIN