Healthcare Provider Details

I. General information

NPI: 1801223078
Provider Name (Legal Business Name): ILA ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 HEALTH DR SW SUITE B
WYOMING MI
49519-9501
US

IV. Provider business mailing address

10159 EAST RIVERSHORE SE
ALTO MI
49302-9683
US

V. Phone/Fax

Practice location:
  • Phone: 616-530-6700
  • Fax:
Mailing address:
  • Phone: 616-530-6700
  • Fax: 616-530-6767

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. KENDRA SUE SCHUMAKER
Title or Position: DIRECTOR
Credential: MSW
Phone: 616-530-6700