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General NPI Number Information
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NPI Number | 1275179103
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Entity Type | Organization
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Legal Business Name | VILLAGE SERVICES
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Dates
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Enumeration Date | 11/26/2019
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Last Update Date | 11/26/2019
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Provider Practice Location Address
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Address Line | 1100 E TINKHAM AVE
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City | LUDINGTON
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State | MI
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Zip | 49431-2728
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Country | US
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Telephone | 231-206-5121
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 E TINKHAM AVE
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City | LUDINGTON
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State | MI
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Zip | 49431-2728
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Country | US
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Telephone | 231-206-5121
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | LISA K MCKINNON
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Credential |
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Telephone | 231-206-5122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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