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Organization
COVENANT LIVING OF THE GREAT LAKES
Active
Organization
COVENANT LIVING OF THE GREAT LAKES
Active
Other names
Covenant Living of the Great Lakes
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH MCLAREN (ASSOCIATE VICE PRESIDENT OF HEALTH)
(773) 878-4430
Entity
Organization
Contact information
Practice address
2520 LAKE MICHIGAN DRIVE NW, GRAND RAPIDS, MI 49504-4696
(616) 735-4541
(616) 735-5900
Mailing address
2520 LAKE MICHIGAN DRIVE NW, GRAND RAPIDS, MI 49504-4696
(616) 735-4541
(616) 735-5900
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
414382
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7974902
—
MI
Enumeration date
09/28/2006
Last updated
01/28/2020
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