Healthcare Provider Details

I. General information

NPI: 1639173362
Provider Name (Legal Business Name): LUTHERAN HOMES OF MICHIGAN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 W GENESEE ST
FRANKENMUTH MI
48734-1316
US

IV. Provider business mailing address

9710 JUNCTION RD. P.O. BOX 329
FRANKENMUTH MI
48734-0329
US

V. Phone/Fax

Practice location:
  • Phone: 989-652-9951
  • Fax: 989-652-0339
Mailing address:
  • Phone: 989-652-3470
  • Fax: 989-652-3480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number734130
License Number StateMI

VIII. Authorized Official

Name: TIMOTHY ROBERT KALBFLEISCH
Title or Position: CFO
Credential:
Phone: 248-635-3316