Healthcare Provider Details

I. General information

NPI: 1649263468
Provider Name (Legal Business Name): PLEASANT VIEW SHIAWASSEE COUNTY MEDICAL CARE FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 01/14/2020
Certification Date: 01/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 N CALEDONIA DR
OWOSSO MI
48867-8844
US

IV. Provider business mailing address

275 N CALEDONIA DR
OWOSSO MI
48867-8844
US

V. Phone/Fax

Practice location:
  • Phone: 989-743-3491
  • Fax: 989-743-8681
Mailing address:
  • Phone: 989-743-3491
  • Fax: 989-743-8681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number788510
License Number StateMI

VIII. Authorized Official

Name: SHANA ESPINOZA
Title or Position: ADMINISTRATOR
Credential:
Phone: 989-743-3491