Provider Demographics
NPI:1851695019
Name:TRIUMPH HOSPITAL NORTHWEST INDIANA. LLC
Entity Type:Organization
Organization Name:TRIUMPH HOSPITAL NORTHWEST INDIANA. LLC
Other - Org Name:KINDRED HOSPITAL NORTHWEST INDIANA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRANCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-596-7220
Mailing Address - Street 1:5454 HOHMAN AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46320-1931
Mailing Address - Country:US
Mailing Address - Phone:219-937-9900
Mailing Address - Fax:219-933-2298
Practice Address - Street 1:5454 HOHMAN AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46320
Practice Address - Country:US
Practice Address - Phone:219-937-9900
Practice Address - Fax:219-933-2298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-03
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN100088991282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
152012Medicare Oscar/Certification