Whalio Doctors

NPI 1033776919

South Coast Home LLC

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility South Haven, MI

Practice location

Address
72633 M 43, South Haven, MI 49090-8734
Phone
(269) 998-9349
Mailing address
PO Box 29, Macatawa, MI 49434-0029

Authorised official

Name
Chester Kwiatkowski
Title
Licensee/Owner
Phone
(269) 998-9349

Registered specialties

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320600000X

Registry record

NPI
1033776919
Entity type
Organization
NPI issued
25 May 2019
Record last updated
26 Feb 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.