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Organization
DEEPWOOD AFC LLC
Active
Organization
DEEPWOOD AFC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA KRAJEWSKI (LICENSEE/DESIGNEE)
(616) 318-1961
Entity
Organization
Contact information
Practice address
1767 DEEPWOOD DR SW, WYOMING, MI 49519-6556
(616) 531-1023
Mailing address
6026 KALAMAZOO AVE SE, STE 296, GRAND RAPIDS, MI 49508-7018
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AS410284040
MI
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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