Organization
ASCENSION HEALTH III AFC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NADINE CARLSON (OWNER)
(248) 342-2698
Entity
Organization
Contact information
Practice address
1947 MILLBANK ST SE, GRAND RAPIDS, MI 49508-2674
(616) 805-4203
Mailing address
210 HODENPYL RD SE, GRAND RAPIDS, MI 49506-2060
(248) 342-2698
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AS410386016
MI
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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