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General NPI Number Information
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NPI Number | 1497988810
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Entity Type | Organization
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Legal Business Name | INDIAN SPRINGS FARM
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Dates
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Enumeration Date | 09/02/2009
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Last Update Date | 09/02/2009
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Provider Practice Location Address
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Address Line | 9521 CONDIT RD
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City | ALBION
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State | MI
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Zip | 49224-9720
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Country | US
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Telephone | 517-629-3439
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Fax |
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Provider Business Mailing Address
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Address Line | 9521 CONDIT RD
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City | ALBION
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State | MI
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Zip | 49224-9720
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Country | US
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Telephone | 517-629-3439
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Fax |
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Authorized Official
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Title or Position | MANGER
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Name | MR. MICHAEL SWARTOUT
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Credential |
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Telephone | 517-629-3439
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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 | AFC130000965
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License Number State | MI
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