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Organization
REST HAVEN ILLIANA CHRISTIAN CONVELESCENT HOME
Active
Organization
REST HAVEN ILLIANA CHRISTIAN CONVELESCENT HOME
Active
Other names
Providence at Home
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN JOHNSON (VICE PRESIDENT)
(708) 342-8126
Entity
Organization
Contact information
Practice address
500 PARKSIDE DR, SUITE 159, ZEELAND, MI 49464-2056
(616) 772-2935
(616) 772-9998
Mailing address
500 PARKSIDE DR, SUITE 159, ZEELAND, MI 49464-2056
(616) 772-2935
(616) 772-9998
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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