NPI 1376083162

Southview Afc LLC

Organisation Adult Care Home Facility Wyoming, MI

Practice location

Address: 70 56th St SW, Wyoming, MI 49548-5739
Phone: (616) 318-1961
Mailing address: 6026 Kalamazoo Ave SE STE 296, Grand Rapids, MI 49508-7018

Authorised official

Name: Debra Krajewski
Title: Licensee/Designee
Phone: (616) 318-1961

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence AS410311381 (MI)

Other Custodial Care Facility providers in Michigan →

Registry record

NPI: 1376083162
Entity type: Organization
NPI issued: 28 Feb 2017
Record last updated: 28 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.