Provider Demographics
NPI:1235415894
Name:R L RINGENBERG MANAGEMENT, LLC
Entity Type:Organization
Organization Name:R L RINGENBERG MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:RINGENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-684-4320
Mailing Address - Street 1:911 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-3414
Mailing Address - Country:US
Mailing Address - Phone:269-684-4320
Mailing Address - Fax:269-684-6744
Practice Address - Street 1:911 S 3RD ST
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-3414
Practice Address - Country:US
Practice Address - Phone:269-684-4320
Practice Address - Fax:269-684-6744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901001507314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1235415894Medicaid
MI235361Medicare Oscar/Certification
WI235361Medicare Oscar/Certification