Healthcare Provider Details

I. General information

NPI: 1922004548
Provider Name (Legal Business Name): THE CONTINUUM OF CLIO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 07/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G13137 CLIO ROAD
CLIO MI
48420-0040
US

IV. Provider business mailing address

G13137 CLIO ROAD PO BOX 40
CLIO MI
48420-0040
US

V. Phone/Fax

Practice location:
  • Phone: 810-686-2600
  • Fax: 810-686-8405
Mailing address:
  • Phone: 810-686-2600
  • Fax: 810-686-8405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number254030
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: SUSAN LYNN TRUSSELL
Title or Position: OFFICE MANAGER
Credential:
Phone: 810-686-2600