Organization
BLOOMINGDALE SENIOR SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY L MCCULLOUGH MSW (DIRECTOR)
(269) 512-6163
Entity
Organization
Contact information
Practice address
01546 COUNTY ROAD 665, BLOOMINGDALE, MI 49026-8756
(269) 512-6163
Mailing address
01546 COUNTY ROAD 665, BLOOMINGDALE, MI 49026-8756
(269) 512-6163
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
332U00000X
Home Delivered Meals
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9689166
—
MI
Enumeration date
07/25/2022
Last updated
07/25/2022
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