Organization
NORTHERN PATHWAYS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCES MARIE WAGNER (LICENSE DESIGNER)
(616) 712-6002
Entity
Organization
Contact information
Practice address
12700 LINCOLN LAKE AVE., GOWEN, MI 49326
(616) 712-6022
Mailing address
12700 LINCOLN LAKE AVE., GOWEN, MI 49326
(616) 712-6002
(616) 712-6002
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
09/03/2021
Last updated
09/03/2021
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