Healthcare Provider Details

I. General information

NPI: 1124958152
Provider Name (Legal Business Name): HM ASSISTED LIVING OF MANISTEE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1967 MAPLE RIDGE DR
MANISTEE MI
49660-9786
US

IV. Provider business mailing address

1967 MAPLE RIDGE DR
MANISTEE MI
49660-9786
US

V. Phone/Fax

Practice location:
  • Phone: 231-794-5037
  • Fax: 231-794-5038
Mailing address:
  • Phone: 231-794-5037
  • Fax: 231-794-5038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW MALETICH
Title or Position: OWNER
Credential:
Phone: 734-777-8839