Healthcare Provider Details

I. General information

NPI: 1417942103
Provider Name (Legal Business Name): PEPLINSKI INVESTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 S HURON RD
KAWKAWLIN MI
48631-9485
US

IV. Provider business mailing address

1395 S HURON RD
KAWKAWLIN MI
48631-9485
US

V. Phone/Fax

Practice location:
  • Phone: 989-684-3210
  • Fax: 989-684-6909
Mailing address:
  • Phone: 989-684-3210
  • Fax: 989-684-6909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number094030
License Number StateMI

VIII. Authorized Official

Name: MR. JEFFERY SCHADE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: NHA
Phone: 989-684-3210