Healthcare Provider Details

I. General information

NPI: 1063039923
Provider Name (Legal Business Name): VISEL AFC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2020
Last Update Date: 06/26/2020
Certification Date: 06/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 WHITNEYVILLE AVE SE
ALTO MI
49302-9027
US

IV. Provider business mailing address

6571 WHITNEYVILLE AVE SE
ALTO MI
49302-9027
US

V. Phone/Fax

Practice location:
  • Phone: 616-868-7478
  • Fax:
Mailing address:
  • Phone: 616-893-6613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: BEN VISEL
Title or Position: PRESIDENT
Credential:
Phone: 616-893-6613