NPI 1235679143

New Outlook

Organisation Adult Care Home Facility Kentwood, MI

Practice location

Address: 3051 Lowry CT SE, Kentwood, MI 49512-5330
Phone: (616) 554-3661

Authorised official

Name: Amanda Deming
Title: Owner/Licensee
Phone: (616) 554-3661

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence AF410285580 (MI)

Other Custodial Care Facility providers in Michigan →

Registry record

NPI: 1235679143
Entity type: Organization
NPI issued: 27 Feb 2017
Record last updated: 27 Feb 2017

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.