Organization
WEST SHORE HOMES AFC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY SCHOLTUS (ADMINISTRATOR/ LICENSE DESIGNEE)
(231) 276-9795
Entity
Organization
Contact information
Practice address
2651 LEAF LN, GRAWN, MI 49637-9605
(231) 276-9795
(231) 276-8038
Mailing address
2651 LEAF LN, PO BOX 128, GRAWN, MI 49637-9605
(231) 276-9795
(231) 276-8038
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AL280312738
MI
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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