Provider Demographics
NPI:1962616292
Name:NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES, INC.
Entity type:Organization
Organization Name:NATIONAL FELLOWSHIP BRETHREN RETIREMENT HOMES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:SONDREA
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-372-6498
Mailing Address - Street 1:337 GRACE VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:WINONA LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46590-5774
Mailing Address - Country:US
Mailing Address - Phone:574-372-6498
Mailing Address - Fax:574-372-6386
Practice Address - Street 1:337 GRACE VILLAGE DR
Practice Address - Street 2:
Practice Address - City:WINONA LAKE
Practice Address - State:IN
Practice Address - Zip Code:46590-5774
Practice Address - Country:US
Practice Address - Phone:574-372-6498
Practice Address - Fax:574-372-6386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable