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Organization

ATRIUM CENTREVILLE LLC

Active
Other names
Fairview Nursing and Rehabilitation Community, Atrium Centreville, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
DENNIS LOCKHART (CHIEF ACCOUNTING OFFICER)
(614) 416-0600
Entity
Organization

Contact information

Practice address
441 E MAIN ST, CENTREVILLE, MI 49032-9626
(269) 467-9575
(269) 467-7077
Mailing address
441 E MAIN ST, CENTREVILLE, MI 49032-9626
(269) 467-9575
(269) 467-7077

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
AH750236782
MI
314000000X
Skilled Nursing Facility
Primary
75-4010
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09715
BCBS PROVIDER CODE
MI
05
60 3079677
MI
Enumeration date
07/11/2005
Last updated
03/03/2025
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