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General NPI Number Information
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NPI Number | 1982226775
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Entity Type | Organization
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Legal Business Name | AUGUST WINTER HOUSE, INC.
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 12/14/2020
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Provider Practice Location Address
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Address Line | 2111 N LATSON RD
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City | HOWELL
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State | MI
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Zip | 48855-9750
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Country | US
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Telephone | 517-618-7144
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Fax | 517-618-7142
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Provider Business Mailing Address
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Address Line | 10686 WACOUSTA RD
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City | DEWITT
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State | MI
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Zip | 48820-8072
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Country | US
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Telephone | 810-922-2938
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Fax | 517-618-7142
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES HOEBERLING
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Credential |
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Telephone | 810-922-2938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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