Organization
BAYFIELD ASSISTED LIVING
Active
Parent organization
LEISURE LIVING MANAGEMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEISURE LIVING MANAGEMENT
Authorized official
MS. SAMANTHA THELEN (DIRECTOR OF OPERATIONS)
(616) 719-5895
Entity
Organization
Contact information
Practice address
3932 MONITOR RD, BAY CITY, MI 48706-9298
(989) 684-9600
(989) 684-9800
Mailing address
3196 KRAFT AVE SE, SUITE 200, GRAND RAPIDS, MI 49512-2078
(616) 464-1564
(616) 464-2470
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
AH090323912
MI
310400000X
Assisted Living Facility
Primary
AH800315846
MI
Other
Enumeration date
08/20/2013
Last updated
03/09/2015
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