NPI 1982099586

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Organisation Custodial Care Facility Berrien Springs, MI

Practice location

Address: 8876 Kephart Ln, Berrien Springs, MI 49103-1440
Phone: (269) 473-7000
Fax: (269) 473-8876

Authorised official

Name: Dyan a Lee
Title: General Manager
Phone: (269) 473-7000

Registered specialties

Custodial Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311Z00000X Licence AF110000791 (MI)

Other Custodial Care Facility providers in Michigan →

Registry record

NPI: 1982099586
Entity type: Organization
NPI issued: 31 Mar 2015
Record last updated: 31 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.