MEDICARE: FULTON RESIDENTIAL CARE CORP

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	:	1497591622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FULTON RESIDENTIAL CARE CORP

Provider Business Mailing Address
First Line	:	1033 E CARO RD
Second Line	:
City	:	CARO
State	:	MI
Zip	:	48723-1203
Country	:	US
Telephone Number	:	989-672-7668
Fax Number	:	989-672-7669

Provider Business Practice Location Address
First Line	:	1572 VAN GEISEN RD
Second Line	:
City	:	CARO
State	:	MI
Zip	:	48723-1303
Country	:	US
Telephone Number	:	989-672-7668
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ROBERT FULTON
Credential	:
Telephone Number	:	989-672-7668

Provider Enumeration Date	:	07/08/2024
Last Update Date	:	07/08/2024

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Directions to “FULTON RESIDENTIAL CARE CORP ” Practice Location

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