# HEARTLAND OF HOLLAND MI LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heartland of Holland
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194766998
- **Authorized official:** MR. BARRY A LAZARUS (VICE PRESIDENT - REIMBURSEMENTS)
- **Authorized official phone:** (419) 252-5541

## Contact information

- **Practice address:** 493 W 32ND ST, HOLLAND, MI 49423-7201
- **Practice address phone:** (616) 396-1438
- **Practice address fax:** (616) 396-2276
- **Mailing address:** 333 N SUMMIT ST, ATTN: BARRY LAZARUS, TOLEDO, OH 43604-1531
- **Mailing address phone:** (419) 252-5541
- **Mailing address fax:** (419) 252-5548

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 9362 | MI | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 06/04/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 605262651 | — | MI |