# GLACIER HILLS INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Glacier Hills
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811936768
- **Authorized official:** PAMELA SUE LATOVICK (VICE PRESIDENT REIMBURSEMENT)
- **Authorized official phone:** (734) 343-6628

## Contact information

- **Practice address:** 1200 EARHART RD, ANN ARBOR, MI 48105-2768
- **Practice address phone:** (734) 769-6410
- **Practice address fax:** (734) 769-5958
- **Mailing address:** 1200 EARHART RD, ANN ARBOR, MI 48105-2768
- **Mailing address phone:** (734) 769-6410
- **Mailing address fax:** (734) 769-5958

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 814110 | MI | Yes |

## Other

- **Enumeration date:** 06/06/2006
- **Last updated:** 09/11/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09522 | BLUE CROSS PROVIDER NUMBE | MI |
| 05 | — | 2080717 | — | MI |