Organization
TAWAS CITY OPCO LLC
Active
Other names
Medilodge of Tawas City
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE RANEL KIRK (DELEGATED OFFICIAL)
(417) 846-3521
Entity
Organization
Contact information
Practice address
400 NORTH ST W, TAWAS CITY, MI 48763-9161
(989) 362-8645
Mailing address
7400 NEW LA GRANGE RD STE 400, LOUISVILLE, KY 40222-4870
(502) 429-8062
(866) 360-1098
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508383837
—
MI
Enumeration date
08/28/2017
Last updated
05/28/2026
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