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General NPI Number Information
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NPI Number | 1841298288
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Entity Type | Organization
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Legal Business Name | ATRIUM CENTREVILLE LLC
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 441 E MAIN ST
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City | CENTREVILLE
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State | MI
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Zip | 49032-9626
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Country | US
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Telephone | 269-467-9575
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Fax | 269-467-7077
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Provider Business Mailing Address
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Address Line | 441 E MAIN ST
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City | CENTREVILLE
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State | MI
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Zip | 49032-9626
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Country | US
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Telephone | 269-467-9575
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Fax | 269-467-7077
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Authorized Official
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Title or Position | CHIEF ACCOUNTING OFFICER
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Name | DENNIS LOCKHART
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Credential |
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Telephone | 614-416-0600
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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 | AH750236782
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 75-4010
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License Number State | MI
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