Organization
ATRIUM ROOSEVELT PARK LLC
Active
Other names
Roosevelt Park Nursing and Rehabilitation Community, Roosevelt Park Nursing Centre, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LOCKHART (CHIEF ACCOUNTING OFFICER)
(614) 416-0600
Entity
Organization
Contact information
Practice address
1300 W BROADWAY AVE, MUSKEGON, MI 49441-3530
(231) 755-2221
(231) 755-3142
Mailing address
1300 W BROADWAY AVE, MUSKEGON, MI 49441-3530
(231) 755-2221
(231) 755-3142
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
61-4080
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09692
BCBS PROVIDER CODE
MI
05
—
60 1642830
—
MI
Enumeration date
07/12/2005
Last updated
03/03/2025
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