Organization
COUNTY OF GRAND TRAVERSE
Active
Other names
Grand Traverse Medical Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KORVYN R HANSEN JR. (CEO/ADMINISTRATOR)
(231) 932-3010
Entity
Organization
Contact information
Practice address
1000 PAVILIONS CIRCLE, TRAVERSE CITY, MI 49684-3198
(231) 932-3000
(231) 932-3009
Mailing address
1000 PAVILIONS CIRCLE, TRAVERSE CITY, MI 49684-3198
(231) 932-3000
(231) 932-3009
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
288510
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3470207-61
—
MI
Enumeration date
10/31/2006
Last updated
11/14/2016
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