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General NPI Number Information
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NPI Number | 1639096340
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Entity Type | Organization
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Legal Business Name | BIG RAPIDS FIELDS ASSISTED LIVING LLC
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Dates
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Enumeration Date | 07/02/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 18900 16 MILE RD
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City | BIG RAPIDS
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State | MI
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Zip | 49307-8727
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Country | US
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Telephone | 231-598-9230
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Fax |
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Provider Business Mailing Address
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Address Line | 18900 16 MILE RD
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City | BIG RAPIDS
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State | MI
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Zip | 49307-8727
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. DOUGLAS BOEHM
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Credential |
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Telephone | 248-930-7875
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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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