Provider Demographics
NPI:1093939043
Name:WHALEY RESIDENTIAL CARE CO
Entity Type:Organization
Organization Name:WHALEY RESIDENTIAL CARE CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-892-0247
Mailing Address - Street 1:PO BOX 1273
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-0273
Mailing Address - Country:US
Mailing Address - Phone:989-892-0247
Mailing Address - Fax:989-892-0906
Practice Address - Street 1:407 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-7851
Practice Address - Country:US
Practice Address - Phone:989-892-0247
Practice Address - Fax:989-892-0906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home