Healthcare Provider Details

I. General information

NPI: 1609461821
Provider Name (Legal Business Name): MOMENTOUS HEALTH AT BATTLE CREEK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 08/03/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 WAGNER DR
BATTLE CREEK MI
49017-5721
US

IV. Provider business mailing address

675 WAGNER DR
BATTLE CREEK MI
49017-5721
US

V. Phone/Fax

Practice location:
  • Phone: 269-969-6244
  • Fax:
Mailing address:
  • Phone: 269-969-6244
  • 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: MICHAEL TENENBAUM
Title or Position: CEO
Credential: LNHA
Phone: 917-613-5764