Organization
SHANGRILA HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DYAN A LEE (GENERAL MANAGER)
(269) 473-7000
Entity
Organization
Contact information
Practice address
8876 KEPHART LN, BERRIEN SPRINGS, MI 49103-1440
(269) 473-7000
(269) 473-8876
Mailing address
8876 KEPHART LN, BERRIEN SPRINGS, MI 49103-1440
(269) 473-7000
(269) 473-8876
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
AF110000791
MI
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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