Organization
CHARLEVOIX NURSING HOME CORPORATION
Active
Other names
Boulder Park Terrace
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID BELLAMY (CFO)
(231) 487-4094
Entity
Organization
Contact information
Practice address
14676 W UPRIGHT ST, CHARLEVOIX, MI 49720-1201
(231) 547-1005
Mailing address
14676 W UPRIGHT ST, CHARLEVOIX, MI 49720-1201
(231) 547-1005
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
235526
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2896882
—
MI
Enumeration date
09/15/2006
Last updated
08/28/2017
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