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General NPI Number Information
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NPI Number | 1609784784
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Entity Type | Organization
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Legal Business Name | BUCHANAN AL OPERATOR LLC
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 809 CAROLL ST
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City | BUCHANAN
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State | MI
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Zip | 49107-1738
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Country | US
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Telephone | 574-261-1124
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W FERRY ST
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City | BERRIEN SPRINGS
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State | MI
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Zip | 49103-1154
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Country | US
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Telephone | 574-261-1124
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Fax |
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Authorized Official
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Title or Position | COO
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Name | TODD DOCKERTY
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Credential |
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Telephone | 574-261-1124
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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 |
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License Number State |
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