NPI 1114351152

Crestwood Village Assisted Living

Organisation Exclusive Provider Organization Mt. Pleasant, MI

Practice location

Address: 2378 South Lincoln Rd, Mt. Pleasant, MI 48858
Phone: (989) 772-2183
Fax: (989) 772-2296
Mailing address: 3196 Kraft Ave SE Suite 200, Grand Rapids, MI 49512-2078

Authorised official

Name: Samantha Thelen
Title: Director of Operations
Phone: (517) 881-6051

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence AH370325563 (MI)

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Registry record

NPI: 1114351152
Entity type: Organization
NPI issued: 27 Aug 2013
Record last updated: 9 Mar 2015

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.