# JORDAN'S NURSING HOME INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013921014
- **Authorized official:** MR. RANDY JORDAN (ADMINISTRATOR)
- **Authorized official phone:** (269) 465-3017

## Contact information

- **Practice address:** 9935 RED ARROW HWY, BRIDGMAN, MI 49106-0607
- **Practice address phone:** (269) 465-3017
- **Practice address fax:** (269) 465-0327
- **Mailing address:** 9935 RED ARROW HWY, BRIDGMAN, MI 49106-0607
- **Mailing address phone:** (269) 465-3017
- **Mailing address fax:** (269) 465-0327

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 114170 | MI | Yes |

## Other

- **Enumeration date:** 07/28/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2151327 | — | MI |