# HEARTWOOD LODGE TRINITY HEALTH

> 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:** 1326034000
- **Authorized official:** PAMELA SUE LATOVICK (VP REIMBURSEMENT)
- **Authorized official phone:** (734) 343-6628

## Contact information

- **Practice address:** 18525 WOODLAND RIDGE DR, SPRING LAKE, MI 49456-8876
- **Practice address phone:** (616) 842-0770
- **Mailing address:** 18525 WOODLAND RIDGE DR, SPRING LAKE, MI 49456-8876
- **Mailing address phone:** (616) 842-0770

## Taxonomy

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

## Other

- **Enumeration date:** 09/27/2005
- **Last updated:** 07/26/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09854 | BLUE CROSS BLUE SHIELD | MI |
| 05 | — | 1326034000 | — | MI |
| 05 | — | 1675500-60 | — | MI |