1750624888 NPI number — HOWELL NURSING, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750624888 NPI number — HOWELL NURSING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOWELL NURSING, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WHITE PINE REHABILITATION & HEALTHCARE OF HOWELL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750624888
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 IONIA AVE SW STE 506
Provider Second Line Business Mailing Address:
WHITE PINE MANAGEMENT, LLC C/O BIG BAY VENTURES, LLC
Provider Business Mailing Address City Name:
GRAND RAPIDS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49503-4179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-991-1388
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3003 W GRAND RIVER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOWELL
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48843-8539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-546-4210
Provider Business Practice Location Address Fax Number:
517-546-7661
Provider Enumeration Date:
03/27/2013

Additional Information

Authorized Official

Authorized Official Last Name:
BOLT
Authorized Official First Name:
BRETTON
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/MANAGER
Authorized Official Telephone Number:
301-991-1388

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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