Provider Demographics
NPI:1164055380
Name:PALMER'S PLACE INC
Entity Type:Organization
Organization Name:PALMER'S PLACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR OF AFC
Authorized Official - Prefix:
Authorized Official - First Name:JENNIA
Authorized Official - Middle Name:MARI
Authorized Official - Last Name:WOODCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-444-1597
Mailing Address - Street 1:11345 W. ST. CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:MI
Mailing Address - Zip Code:48889
Mailing Address - Country:US
Mailing Address - Phone:989-444-1597
Mailing Address - Fax:
Practice Address - Street 1:1009 S. ST. JOHNS RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:MI
Practice Address - Zip Code:48847
Practice Address - Country:US
Practice Address - Phone:989-875-3745
Practice Address - Fax:989-875-3759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility