Organization
RIVER RIDGE RETIREMENT VILLAGE L L C
Active
Other names
River Ridge Retirement Village - Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS NOBEL (PRESIDENT)
(269) 639-7310
Entity
Organization
Contact information
Practice address
706 KENTUCKY AVE, SOUTH HAVEN, MI 49090-9607
(269) 639-7310
Mailing address
706 KENTUCKY AVE, SOUTH HAVEN, MI 49090-9607
(269) 639-7310
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
23D1102188
MI
Other
Enumeration date
09/24/2010
Last updated
03/17/2011
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