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General NPI Number Information
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NPI Number | 1457354268
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Entity Type | Organization
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Legal Business Name | COUNTY OF ALLEGAN
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 3265 122ND AVE
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City | ALLEGAN
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State | MI
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Zip | 49010-9511
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Country | US
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Telephone | 269-673-2102
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Fax | 269-673-6199
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Provider Business Mailing Address
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Address Line | 3265 122ND AVE
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City | ALLEGAN
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State | MI
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Zip | 49010-9511
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Country | US
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Telephone | 269-673-2102
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Fax | 269-673-6199
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. KIMBERLY TURCOTT
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Credential | NHA
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Telephone | 269-673-2102
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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 | 038510
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License Number State | MI
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