NPI 1073002606 · live from the CMS NPI Registry
Crestview Snf, LLC
Skilled Nursing Facility in Wyoming, MI. National Provider Identifier 1073002606, active.
NPI record
| NPI | 1073002606 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 625 36th St Sw, Wyoming, MI 49509 |
| Practice phone | 616-531-0200 |
| Mailing address | 620 Davis St Ste 200, Evanston, IL 60201 |
| Enumerated | May 9, 2018 |
| Last updated | August 17, 2018 |
| Authorized official | Yair Zuckerman, Manager |
| Other names | Skld Wyoming; Illuminate Hc Wyoming |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.