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General NPI Number Information
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NPI Number | 1730565946
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Entity Type | Organization
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Legal Business Name | RETIREMENT LIVING MANAGEMENT OF FREMONT, L.L.C.
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 08/11/2015
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Provider Practice Location Address
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Address Line | 801 E. MAIN STREET
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City | FREMONT
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State | MI
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Zip | 49412
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Country | US
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Telephone | 231-335-2060
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Fax |
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Provider Business Mailing Address
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Address Line | 801 E. MAIN STREET
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City | FREMONT
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State | MI
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Zip | 49412
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Country | US
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Telephone | 231-335-2060
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FAYE FISHER
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Credential |
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Telephone | 231-335-2060
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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 | AL620366250
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License Number State | MI
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