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General NPI Number Information
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NPI Number | 1497184758
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Entity Type | Organization
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Legal Business Name | WELCOME HOME ASSISTED LIVING, INC.
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Dates
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Enumeration Date | 11/07/2013
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 1605 VANDEKARR RD
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City | OWOSSO
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State | MI
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Zip | 48867-9757
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Country | US
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Telephone | 989-277-9292
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Fax |
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Provider Business Mailing Address
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Address Line | 660 ELIZABETH DR
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City | OWOSSO
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State | MI
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Zip | 48867-9149
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Country | US
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Telephone | 989-277-9292
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KIMBERLY MARIE BOWEN
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Credential | RN
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Telephone | 989-277-9292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AM190292029
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License Number State | MI
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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 | AS780313707
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License Number State | MI
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