Healthcare Provider Details

I. General information

NPI: 1194199778
Provider Name (Legal Business Name): WHITEHILLS HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2015
Last Update Date: 11/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1843 N HAGADORN RD
EAST LANSING MI
48823-2229
US

IV. Provider business mailing address

1843 N HAGADORN RD
EAST LANSING MI
48823-2229
US

V. Phone/Fax

Practice location:
  • Phone: 517-332-5061
  • Fax: 517-332-5063
Mailing address:
  • Phone: 517-332-5061
  • Fax: 517-332-5063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number334100
License Number StateMI

VIII. Authorized Official

Name: MR. CHAUNCEY R DUNBAR
Title or Position: CFO
Credential: CPA
Phone: 601-956-1013