Organization
BARUCH SLS, INC
Active
Other names
Lakeshore Assisted Living Homes
Organization subpart
No
Provider details
NPI number
Authorized official
MISSY DARWIN (ADMINISTRATOR)
(616) 847-4243
Entity
Organization
Contact information
Practice address
16216 MERCURY DR, GRAND HAVEN, MI 49417-2918
(616) 847-4243
Mailing address
3196 KRAFT AVE SE, SUITE200, GRAND RAPIDS, MI 49512-2078
(616) 464-1564
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AM700009433
MI
310400000X
Assisted Living Facility
AM70009430
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23D2004741
CLIA
MI
Enumeration date
08/24/2010
Last updated
08/24/2010
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