Organization
PINECREST FARMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE BLEWETT (ADMINISTRATOR)
(989) 832-6634
Entity
Organization
Contact information
Practice address
413 N HOMER RD, MIDLAND, MI 48640-8646
(989) 832-6634
(989) 837-0666
Mailing address
413 N HOMER RD, MIDLAND, MI 48640-8646
(989) 832-6634
(989) 837-0666
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
A1560000004
MI
3104A0625X
Assisted Living Facility (Mental Illness)
A1560000004
MI
311500000X
Alzheimer Center (Dementia Center)
A1560000004
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0892955
—
MI
Enumeration date
10/02/2014
Last updated
10/02/2014
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