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Organization

HEARTWOOD LODGE TRINITY HEALTH

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAMELA SUE LATOVICK (VP REIMBURSEMENT)
(734) 343-6628
Entity
Organization

Contact information

Practice address
18525 WOODLAND RIDGE DR, SPRING LAKE, MI 49456-8876
(616) 842-0770
Mailing address
18525 WOODLAND RIDGE DR, SPRING LAKE, MI 49456-8876
(616) 842-0770

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09854
BLUE CROSS BLUE SHIELD
MI
05
1326034000
MI
05
1675500-60
MI
Enumeration date
09/27/2005
Last updated
07/26/2023
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