Provider Demographics
NPI:1164811527
Name:ALVIN G. FERDINAND INC.
Entity Type:Organization
Organization Name:ALVIN G. FERDINAND INC.
Other - Org Name:BRIDGMAN RETIREMENT HOME #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDEOSINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-426-6264
Mailing Address - Street 1:11880 GAST RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49106-9390
Mailing Address - Country:US
Mailing Address - Phone:269-426-6264
Mailing Address - Fax:
Practice Address - Street 1:11880 GAST RD
Practice Address - Street 2:
Practice Address - City:BRIDGMAN
Practice Address - State:MI
Practice Address - Zip Code:49106-9390
Practice Address - Country:US
Practice Address - Phone:269-426-6264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAL110095313305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service