Healthcare Provider Details

I. General information

NPI: 1487237392
Provider Name (Legal Business Name): BATTLE CREEK SNF OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ROOSEVELT AVE E
BATTLE CREEK MI
49037-2829
US

IV. Provider business mailing address

777 E MAIN ST STE 210
WESTFIELD IN
46074-5301
US

V. Phone/Fax

Practice location:
  • Phone: 269-965-3327
  • Fax:
Mailing address:
  • Phone: 317-288-4029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: PAUL PRUITT
Title or Position: OFFICER
Credential:
Phone: 317-288-4029