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Organization

FERNY AFC HOME LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TIMOTHY RANTZ (LICENSEE DESIGNEE)
(269) 449-5400
Entity
Organization

Contact information

Practice address
1564 N M 63, BENTON HARBOR, MI 49022-2759
(269) 449-5400
(269) 999-1030
Mailing address
1564 N M 63, BENTON HARBOR, MI 49022-2759
(269) 449-5400
(269) 999-1030

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Enumeration date
10/16/2013
Last updated
03/29/2024
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