Organization
CRESTWOOD VILLAGE ASSISTED LIVING
Active
Parent organization
LEISURE LIVING MANAGEMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEISURE LIVING MANAGEMENT
Authorized official
MS. SAMANTHA THELEN (DIRECTOR OF OPERATIONS)
(517) 881-6051
Entity
Organization
Contact information
Practice address
2378 SOUTH LINCOLN RD, MT. PLEASANT, MI 48858
(989) 772-2183
(989) 772-2296
Mailing address
3196 KRAFT AVE SE, SUITE 200, GRAND RAPIDS, MI 49512-2078
(616) 464-1564
(616) 464-2470
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
AH370325563
MI
Other
Enumeration date
08/27/2013
Last updated
03/09/2015
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