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Organization

FANNVIEW AFC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NADINE CARLSON (OWNER)
(248) 342-2698
Entity
Organization

Contact information

Practice address
1948 MILLBANK ST SE, GRAND RAPIDS, MI 49508-2673
(616) 350-9124
Mailing address
210 HODENPYL RD SE, GRAND RAPIDS, MI 49506-2060
(248) 342-2698

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AS410317479
MI
385H00000X
Respite Care
AS410317479
MI

Other

Enumeration date
02/14/2017
Last updated
02/14/2017
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