Organization
BETHANY CARE CENTER L.L.C
Active
Other names
Metron of Bloomingdale
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J LINDSEY DOOD (EXECUTIVE VICE PRESIDENT / CFO)
(616) 975-5287
Entity
Organization
Contact information
Practice address
42235 COUNTY ROAD 390, BLOOMINGDALE, MI 49026-8753
(269) 521-3383
(269) 521-3370
Mailing address
3075 ORCHARD VISTA DR SE, SUITE 100, GRAND RAPIDS, MI 49546-7069
(616) 957-3957
(616) 957-1556
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
804010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3018617
—
MI
01
—
9742
BLUE CROSS
MI
Enumeration date
08/13/2006
Last updated
11/21/2008
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