Organization
GRACEWAY SOUTH HAVEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY FISCHER (CEO)
(734) 624-4887
Entity
Organization
Contact information
Practice address
120 BASELINE RD, SOUTH HAVEN, MI 49090-1037
(269) 637-8411
Mailing address
1001 WOODWARD AVE FL 5, DETROIT, MI 48226-1904
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/07/2019
Last updated
01/07/2019
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