Healthcare Provider Details

I. General information

NPI: 1013707090
Provider Name (Legal Business Name): BELDING SUNRISE MANOR AFC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 HARRISON ST
BELDING MI
48809-1802
US

IV. Provider business mailing address

532 HARRISON ST
BELDING MI
48809-1802
US

V. Phone/Fax

Practice location:
  • Phone: 231-629-9330
  • Fax: 616-244-3443
Mailing address:
  • Phone: 231-629-9330
  • Fax: 616-244-3443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code310500000X
TaxonomyMental Illness Intermediate Care Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: RONALD ALLEN VAUGHN
Title or Position: ADMINISTRATOR
Credential:
Phone: 231-629-9330