Provider Demographics
NPI:1114130499
Name:PORTER HILLS RETIREMENT COMMUNITIES & SERVICES
Entity Type:Organization
Organization Name:PORTER HILLS RETIREMENT COMMUNITIES & SERVICES
Other - Org Name:SUNSHINE SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:616-949-5140
Mailing Address - Street 1:4450 CASCADE RD SE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-8330
Mailing Address - Country:US
Mailing Address - Phone:616-949-5140
Mailing Address - Fax:616-575-5123
Practice Address - Street 1:4450 CASCADE RD SE
Practice Address - Street 2:SUITE 300
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-8330
Practice Address - Country:US
Practice Address - Phone:616-949-5140
Practice Address - Fax:616-575-5123
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PORTER HILLS HOME HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-07
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management