Healthcare Provider Details

I. General information

NPI: 1851481881
Provider Name (Legal Business Name): SPRING ARBOR MANOR CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 2ND ST
SPRING ARBOR MI
49283-9647
US

IV. Provider business mailing address

PO BOX 550
SPRING ARBOR MI
49283-0550
US

V. Phone/Fax

Practice location:
  • Phone: 517-750-1900
  • Fax: 517-750-3742
Mailing address:
  • Phone: 517-750-1900
  • Fax: 517-750-3742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number384170
License Number StateMI

VIII. Authorized Official

Name: MR. KEVIN JAY GANTON
Title or Position: ADMINISTRATOR
Credential:
Phone: 517-750-1900