| Organization Name: | TIMBERLINE LODGE INC. AFC |
| NPI Number: | 1164852240 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTINE DIEGEL (ADMINISTRATOR) |
| Mailing Address: | 3771 Colwood Rd Caro |
| State: | MI US |
| Postal Code: | 487239732 |
| Phone Number: | 9896734990 |
| Fax Number: | 9896734991 |
| NPI Enumeration Date: | 11/26/2013 |
| NPI Last Update Date: | 11/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 311ZA0620X |
| License Number: | AM790009691 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Custodial Care Facility |
| Taxonomy Specialization: | Adult Care Home |
| Taxonomy Definition: | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |