# MICHIGAN STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750575031
- **Authorized official:** LISA RUCKER (ENROLLMENT & PATIENT ACCTS MANAGER)
- **Authorized official phone:** (517) 884-2976

## Contact information

- **Practice address:** 3860 DOBIE RD, OKEMOS, MI 48864-3704
- **Practice address phone:** (517) 381-6100
- **Practice address fax:** (517) 381-6014
- **Mailing address:** 804 SERVICE RD \# A109F, EAST LANSING, MI 48824-7015
- **Mailing address phone:** (517) 884-2976
- **Mailing address fax:** (517) 432-3928

## Taxonomy

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

## Other

- **Enumeration date:** 08/30/2007
- **Last updated:** 04/05/2018