Organization
FMG WEST FOURTH STREET MICHIGAN LLC
Active
Other names
Tendercare Health Center of Leelanau
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KEATING (AUTHORIZED OFFICIAL)
(414) 908-8058
Entity
Organization
Contact information
Practice address
124 W FOURTH ST, SUTTONS BAY, MI 49682-9733
(231) 271-1200
(231) 271-1214
Mailing address
124 W FOURTH ST, SUTTONS BAY, MI 49682-9733
(231) 271-1200
(231) 271-1214
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/17/2014
Last updated
12/23/2014
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