Organization
CRESTVIEW SNF, LLC
Active
Other names
Illuminate HC Wyoming, SKLD Wyoming
Organization subpart
No
Provider details
NPI number
Authorized official
YAIR ZUCKERMAN (MANAGER)
(773) 517-4777
Entity
Organization
Contact information
Practice address
625 36TH ST SW, WYOMING, MI 49509
(616) 531-0200
Mailing address
620 DAVIS ST STE 200, EVANSTON, IL 60201-4419
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/09/2018
Last updated
08/17/2018
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