Provider Demographics
NPI:1144313263
Name:MID-MICHIGAN HEALTH CARE ASSOCIATES,LTD
Entity type:Organization
Organization Name:MID-MICHIGAN HEALTH CARE ASSOCIATES,LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:ROSLUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-463-2200
Mailing Address - Street 1:842 W WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1178
Mailing Address - Country:US
Mailing Address - Phone:989-463-2200
Mailing Address - Fax:989-463-2543
Practice Address - Street 1:842 W WARWICK DRIVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1178
Practice Address - Country:US
Practice Address - Phone:989-463-2200
Practice Address - Fax:989-463-2543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI294060314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI60-1881553Medicaid
MI60-1881553Medicaid