Provider Demographics
NPI:1093053696
Name:HOWELL NURSING, LLC
Entity Type:Organization
Organization Name:HOWELL NURSING, LLC
Other - Org Name:WHITE PINE REHABILITATION & HEALTHCARE OF HOWELL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRETTON
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-991-1388
Mailing Address - Street 1:25 IONIA AVE SW STE 506
Mailing Address - Street 2:WHITE PINE MANAGEMENT, LLC C/O BIG BAY VENTURES, LLC
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4179
Mailing Address - Country:US
Mailing Address - Phone:301-991-1388
Mailing Address - Fax:
Practice Address - Street 1:3003 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8539
Practice Address - Country:US
Practice Address - Phone:517-546-4210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility