# COUNTY OF GRAND TRAVERSE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grand Traverse Medical Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326124322
- **Authorized official:** MR. KORVYN R HANSEN JR. (CEO/ADMINISTRATOR)
- **Authorized official phone:** (231) 932-3010

## Contact information

- **Practice address:** 1000 PAVILIONS CIRCLE, TRAVERSE CITY, MI 49684-3198
- **Practice address phone:** (231) 932-3000
- **Practice address fax:** (231) 932-3009
- **Mailing address:** 1000 PAVILIONS CIRCLE, TRAVERSE CITY, MI 49684-3198
- **Mailing address phone:** (231) 932-3000
- **Mailing address fax:** (231) 932-3009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 288510 | MI | Yes |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 11/14/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3470207-61 | — | MI |