NPI 1275511487 · live from the CMS NPI Registry
Blue Water Nursing Center
Skilled Nursing Facility in Fort Gratiot, MI. National Provider Identifier 1275511487, active.
NPI record
| NPI | 1275511487 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 5635 Lakeshore Rd, Fort Gratiot, MI 48059 |
| Practice phone | 810-385-7447 |
| Enumerated | January 6, 2006 |
| Last updated | August 22, 2020 |
| Authorized official | Lawrence Petroskey, Cfo |
| Other names | Evangelical Home - Port Huron |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | 744060 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.