=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679659288
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARGENTINE CARE CENTER, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2006
-----------------------------------------------------
Last Update Date | 09/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9051 SILVER LAKE RD
-----------------------------------------------------
City | LINDEN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48451-9730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-735-9487
-----------------------------------------------------
Fax | 810-735-9035
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9051 SILVER LAKE RD
-----------------------------------------------------
City | LINDEN
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48451-9730
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-735-9487
-----------------------------------------------------
Fax | 810-735-9035
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | MRS. KERRI STIVERSON MESSER
-----------------------------------------------------
Credential | LNHA
-----------------------------------------------------
Telephone | 810-735-9487
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 313M00000X
-----------------------------------------------------
Taxonomy Name | Nursing Facility/Intermediate Care Facility
-----------------------------------------------------
License Number | 254170
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------