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General NPI Number Information
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NPI Number | 1205560315
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Entity Type | Organization
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Legal Business Name | SKAGGS ASSISTED LIVING, LLC.
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 285 MCMAHON DR
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City | BRONSON
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State | MI
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Zip | 49028-9434
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Country | US
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Telephone | 517-617-4058
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Fax | 517-858-1062
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Provider Business Mailing Address
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Address Line | 285 MCMAHON DR
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City | BRONSON
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State | MI
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Zip | 49028-9434
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Country | US
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Telephone | 517-617-4058
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Fax | 517-858-1062
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JULIA SUE SKAGGS
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Credential | BSN,RN.
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Telephone | 517-617-4058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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