Organization
ATRIUM SOUTH HAVEN LLC
Active
Other names
South Haven Nursing and Rehabilitation Community, Atrium South Haven, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LOCKHART (CHIEF ACCOUNTING OFFICER)
(614) 416-0600
Entity
Organization
Contact information
Practice address
850 PHILLIPS ST, SOUTH HAVEN, MI 49090-1845
(269) 637-5147
(269) 637-4943
Mailing address
850 PHILLIPS ST, SOUTH HAVEN, MI 49090-1845
(269) 637-5147
(269) 637-4943
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
80-4030
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09947
BCBS PROVIDER CODE
MI
05
—
60 3495037
—
MI
Enumeration date
07/12/2005
Last updated
03/03/2025
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