# TENDERCARE MICHIGAN INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tendercare Health Center of Wyoming
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568591733
- **Authorized official:** MS. DONNA JO THIEL (DIRECTOR OF COMPLIANCE)
- **Authorized official phone:** (414) 908-8119

## Contact information

- **Practice address:** 2786 56TH ST SW, WYOMING, MI 49418-8708
- **Practice address phone:** (616) 261-3690
- **Practice address fax:** (616) 261-3925
- **Mailing address:** 111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
- **Mailing address phone:** (414) 908-8119
- **Mailing address fax:** (414) 908-8481

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 414384 | MI | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 02/19/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 605204498 | — | MI |