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Organization
SPECTRUM HEALTH KELSEY
Active
Organization
SPECTRUM HEALTH KELSEY
Active
Other names
Spectrum Health Rehab & Nursing Centers - Kelsey
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN K JOHNSON (VP FINANCE)
(616) 225-6310
Entity
Organization
Contact information
Practice address
418 WASHINGTON ST, LAKEVIEW, MI 48850-9806
(989) 352-7211
Mailing address
418 WASHINGTON ST, LAKEVIEW, MI 48850-9806
(989) 352-7211
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
593020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09605
BLUE CROSS BLUE SHIELD
MI
05
—
622000387
—
MI
Enumeration date
09/12/2007
Last updated
06/03/2014
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