# PORTER HILLS PRESBYTERIAN VILLAGE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PORTER HILLS PRESBYTERIAN VILLAGE, INC., Porter Hills Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326013830
- **Authorized official:** NICOLE LYNN MAAG (CHIEF RESIDENTIAL OFFICER)
- **Authorized official phone:** (616) 460-9441

## Contact information

- **Practice address:** 3600 E FULTON STREET, GRAND RAPIDS, MI 49546-1322
- **Practice address phone:** (616) 949-4971
- **Practice address fax:** (616) 974-1986
- **Mailing address:** 4450 CASCADE ROAD SE, SUITE 200, GRAND RAPIDS, MI 49546-8330
- **Mailing address phone:** (616) 949-4975
- **Mailing address fax:** (616) 954-1795

## Taxonomy

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

## Other

- **Enumeration date:** 02/19/2006
- **Last updated:** 03/29/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2081429 | — | MI |