Healthcare Provider Details

I. General information

NPI: 1538639760
Provider Name (Legal Business Name): SNUG HARBOR ADULT DAY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2018
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N WASHINGTON AVE
LUDINGTON MI
49431-1864
US

IV. Provider business mailing address

301 N WASHINGTON AVE
LUDINGTON MI
49431-1864
US

V. Phone/Fax

Practice location:
  • Phone: 231-425-9292
  • Fax:
Mailing address:
  • Phone: 231-425-9292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. CONNIE WADE
Title or Position: OFFICE MANAGER
Credential:
Phone: 231-425-9292