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Organization

NAVI GROUP VENTURE I

Active
Other names
VILLA AT THE LAKE
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHRISTOPHER C RANDALL (CEO)
(269) 624-4841
Entity
Organization

Contact information

Practice address
48 PARRISH RD, CONNEAUT, OH 44030-1195
(440) 599-1999
(440) 593-1259
Mailing address
300 WHITE OAK RD, LAWTON, MI 49065-9541
(269) 624-4841

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2261-RCF
OH

Other

Enumeration date
11/27/2007
Last updated
02/24/2009
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