Organization
GAHC3 NILES MI ALF TRS SUB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANNY PROSKY (AUTHORIZED REPRESENTATIVE)
(949) 270-9200
Entity
Organization
Contact information
Practice address
1147 S 3RD ST, NILES, MI 49120-3472
(269) 910-7467
Mailing address
1147 SOUTH THIRD STREET, NILES, MI 49120
(269) 910-7467
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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