Healthcare Provider Details

I. General information

NPI: 1417274945
Provider Name (Legal Business Name): MAGNUM HEALTH AND REHAB OF CLARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SE 4TH ST
CLARE MI
48617-9201
US

IV. Provider business mailing address

600 SE 4TH ST
CLARE MI
48617-9201
US

V. Phone/Fax

Practice location:
  • Phone: 989-386-7723
  • Fax:
Mailing address:
  • Phone:
  • 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: AVI KLEIN
Title or Position: PRESIDENT
Credential:
Phone: 786-888-3310