CCN: 146095 NPI: 1558314302 Organization

EVENGLOW LODGE

215 E WASHINGTON ST
PONTIAC, IL 617642011

Contact Information

Phone 8158446131
Fax 8158423558
Enumeration Date 2006-05-19
Last Updated 2008-04-17

Taxonomies

Code: 314000000X (Primary) License State: IL License: 0008425

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 3

cbsaActualGeographicLocation 14

providerType 38

vbpAdjustment 1.0125745519

censusDivision 3

cbsaActualGeographicLocation 14

providerType 38

vbpAdjustment 0.9938319009

censusDivision 0

cbsaActualGeographicLocation 14

providerType 38

vbpAdjustment 1.0167403748

censusDivision 0

cbsaActualGeographicLocation 14

providerType 38

vbpAdjustment 0.992

censusDivision 0

cbsaActualGeographicLocation 14

providerType 38

vbpAdjustment 0.992

censusDivision 0

cbsaActualGeographicLocation 14

providerType 38

vbpAdjustment 1.0157062132

censusDivision 0

cbsaActualGeographicLocation 14

providerType 38

vbpAdjustment 0.9807953351

censusDivision 0

cbsaActualGeographicLocation 14

providerType 38

vbpAdjustment 1.0146988705

censusDivision 0

cbsaActualGeographicLocation 14

providerType 38

vbpAdjustment 1.0146988705

Outpatient Payment Attributes (OPSF) View Dictionary →

No OPSF records found for this provider.