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General NPI Number Information
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NPI Number | 1912963190
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Entity Type | Organization
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Legal Business Name | BORGESS NURSING HOME INC
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 3057 GULL RD
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City | KALAMAZOO
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State | MI
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Zip | 49048-1281
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Country | US
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Telephone | 269-552-6500
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Fax | 269-552-6510
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Provider Business Mailing Address
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Address Line | 3057 GULL RD
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City | KALAMAZOO
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State | MI
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Zip | 49048-1281
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Country | US
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Telephone | 269-552-6500
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Fax | 269-552-6510
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Authorized Official
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Title or Position | COO
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Name | KELLIE GRONEFELD
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Credential |
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Telephone | 314-729-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 394120
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License Number State | MI
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