Provider Demographics
NPI:1063039923
Name:VISEL AFC, INC.
Entity Type:Organization
Organization Name:VISEL AFC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VISEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-893-6613
Mailing Address - Street 1:6571 WHITNEYVILLE AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALTO
Mailing Address - State:MI
Mailing Address - Zip Code:49302-9027
Mailing Address - Country:US
Mailing Address - Phone:616-893-6613
Mailing Address - Fax:
Practice Address - Street 1:6565 WHITNEYVILLE AVE SE
Practice Address - Street 2:
Practice Address - City:ALTO
Practice Address - State:MI
Practice Address - Zip Code:49302-9027
Practice Address - Country:US
Practice Address - Phone:616-868-7478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-26
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home