Organization Name: | OLD FARM LIVING CENTER |
NPI Number: | 1518393669 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PATRICIA KAY CASE (OWNER) |
Mailing Address: | 2689 E Snow Rd Berrien Springs |
State: | MI US |
Postal Code: | 491039637 |
Phone Number: | 2694733946 |
Fax Number: | 2694731518 |
NPI Enumeration Date: | 09/20/2013 |
NPI Last Update Date: | 09/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | AF110065445 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |