Organization
WOODLAWN MEADOWS RETIREMENT VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON VANHOUTEN (ADMINISTRATOR)
(269) 948-4921
Entity
Organization
Contact information
Practice address
1821 N EAST ST, HASTINGS, MI 49058-1367
(269) 948-4921
Mailing address
3196 KRAFT AVE SE, SUITE 200, GRAND RAPIDS, MI 49512-2078
(616) 464-1564
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
AL080242121
MI
310400000X
Assisted Living Facility
Primary
AL080242139
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23D1046098
CLIA
MI
Enumeration date
11/24/2009
Last updated
11/24/2009
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