Organization
BARUCH SLS, INC.
Active
Other names
Lakeshore Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE L CLAUSON (VP OPERATIONS)
(616) 285-0573
Entity
Organization
Contact information
Practice address
16331 ROBBINS RD, GRAND HAVEN, MI 49417-8903
(616) 847-4242
Mailing address
3196 KRAFT AVE SE STE 203, GRAND RAPIDS, MI 49512-2065
(616) 285-0573
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23D2004740
CLIA
MI
Enumeration date
09/24/2010
Last updated
09/25/2020
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