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Organization
FMG RANDOM LANE MICHIGAN LLC
Active
Organization
FMG RANDOM LANE MICHIGAN LLC
Active
Other names
Tendercare Gaylord
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KEATING (AUTHORIZED OFFICIAL)
(414) 908-8058
Entity
Organization
Contact information
Practice address
508 RANDOM LN, GAYLORD, MI 49735-9304
(989) 732-3508
(989) 731-5260
Mailing address
508 RANDOM LN, GAYLORD, MI 49735-9304
(989) 732-3508
(989) 731-5260
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/17/2014
Last updated
12/23/2014
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