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NPI 1194763581

NPI 1194763581 : HEARTLAND OF BATTLE CREEK MI LLC : BATTLE CREEK, MI

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General NPI Number Information
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    NPI Number           |    1194763581
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    Entity Type          |    Organization 
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    Legal Business Name  |    HEARTLAND OF BATTLE CREEK MI LLC 
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Dates
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    Enumeration Date     |    06/04/2006
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    Last Update Date     |    05/23/2017
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Provider Practice Location Address
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    Address Line         |    200 ROOSEVELT AVE E 
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    City                 |    BATTLE CREEK
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    State                |    MI
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    Zip                  |    49017-2829
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    Country              |    US
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    Telephone            |    269-965-3327
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    Fax                  |    269-965-7853
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Provider Business Mailing Address
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    Address Line         |    333 N SUMMIT ST 
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    City                 |    TOLEDO
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    State                |    OH
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    Zip                  |    43604-2615
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    Country              |    US
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    Telephone            |    419-252-5500
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    Fax                  |    877-385-9446
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |    MR. MARTIN D ALLEN 
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    Credential           |    
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    Telephone            |    419-252-5734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    314000000X
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    Taxonomy Name        |    Skilled Nursing Facility
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    License Number       |    134090
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    License Number State |    MI
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