Organization
COUNTY OF BARRY
Active
Other names
Thornapple Manor
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA K DEHAAN (ADMINISTRATOR)
(269) 945-2407
Entity
Organization
Contact information
Practice address
2700 NASHVILLE RD, HASTINGS, MI 49058-8824
(269) 945-2407
(269) 945-5380
Mailing address
2700 NASHVILLE RD, HASTINGS, MI 49058-8824
(269) 945-2407
(269) 945-5380
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
088510
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09642
BLUE CROSS/BLUE SHIELD
MI
05
—
2085099
—
MI
05
—
2151407
—
MI
Enumeration date
08/14/2005
Last updated
04/25/2024
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