Provider Demographics
NPI:1093261414
Name:APPLEDORN ASSISTED LIVING CENTER NORTH
Entity Type:Organization
Organization Name:APPLEDORN ASSISTED LIVING CENTER NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-846-4700
Mailing Address - Street 1:411 IDA RED PKWY
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-2230
Mailing Address - Country:US
Mailing Address - Phone:616-393-0828
Mailing Address - Fax:
Practice Address - Street 1:411 IDA RED PKWY
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-2230
Practice Address - Country:US
Practice Address - Phone:616-393-0828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAH700357088310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility