MEDICARE: CRESTWOOD MANOR, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1316066616
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESTWOOD MANOR, LLC

Provider Business Mailing Address
First Line	:	5078 SOLVEL ST
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49004-1915
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5078 SOLVEL ST
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49004-1915
Country	:	US
Telephone Number	:	269-276-9371
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GADO A ONGWELA
Credential	:
Telephone Number	:	269-276-9371

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1134558455 — BROOKSIDE CARE LLC
Practice Location Address:

5078 SOLVEL ST
KALAMAZOO, MI
49004-1915

Practice Phone: 269-373-3842
Practice Fax:

1255894358 — DEBORAH JANE HINDMAN
Practice Location Address:

1915 WAITE AVE
KALAMAZOO, MI
49008-1760

Practice Phone: 269-377-6060
Practice Fax:

1376547208 — DR. DAVID THOMAS BROWN DDS
Practice Location Address:

2134 E G AVE
KALAMAZOO, MI
49004-1751

Practice Phone: 269-349-4231
Practice Fax:

1154335057 — DR. SAMBHAVITA RANGRASS D.D.S.
Practice Location Address:

1719 E G AVE
KALAMAZOO, MI
49004-1703

Practice Phone: 269-382-5327
Practice Fax: 269-382-2129

1811085475 — JAMES BRYON NEWTON P.A.-C.
Practice Location Address:

4249 PINE KNOLL AVE
KALAMAZOO, MI
49004-9506

Practice Phone: 269-491-0947
Practice Fax:

1730268160 — DR. PAUL T. ORLEY DDS
Practice Location Address:

2410 E G AVE
KALAMAZOO, MI
49004-1943

Practice Phone: 269-349-7393
Practice Fax:

Directions to “CRESTWOOD MANOR, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.