# FMG NORTH STREET WEST MICHIGAN LLC

> 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
- **Other names:** Tendercare Tawas City
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396143665
- **Authorized official:** DAVID KEATING (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (414) 908-8058

## Contact information

- **Practice address:** 400 NORTH ST W, TAWAS CITY, MI 48763-9161
- **Practice address phone:** (989) 362-8645
- **Practice address fax:** (989) 362-4462
- **Mailing address:** 400 NORTH ST W, TAWAS CITY, MI 48763-9161
- **Mailing address phone:** (989) 362-8645
- **Mailing address fax:** (989) 362-4462

## Taxonomy

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

## Other

- **Enumeration date:** 12/18/2014
- **Last updated:** 12/23/2014