Organization
FMG RANDOM LANE MICHIGAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KEATING (AUTHORIZED OFFICIAL)
(414) 908-8058
Entity
Organization
Contact information
Practice address
508 RANDOM LN, GAYLORD, MI 49735-9304
(989) 732-2508
(989) 731-5260
Mailing address
508 RANDOM LN, GAYLORD, MI 49735-9304
(989) 732-2508
(989) 731-5260
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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