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Organization
TIMBERLINE LODGE INC. AFC
Active
Organization
TIMBERLINE LODGE INC. AFC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE DIEGEL (ADMINISTRATOR)
(989) 673-4990
Entity
Organization
Contact information
Practice address
3771 COLWOOD RD, CARO, MI 48723-9732
(989) 673-4990
(989) 673-4991
Mailing address
3771 COLWOOD RD, CARO, MI 48723-9732
(989) 673-4990
(989) 673-4991
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AM790009691
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AM790009691
LICENSE NUMBER
MI
Enumeration date
11/26/2013
Last updated
11/26/2013
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