Provider Demographics
NPI:1326430117
Name:CRETSINGER CARE HOMES, LTD.
Entity Type:Organization
Organization Name:CRETSINGER CARE HOMES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CRETSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-579-7512
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49016-0279
Mailing Address - Country:US
Mailing Address - Phone:269-721-3792
Mailing Address - Fax:269-721-3794
Practice Address - Street 1:4171 CAPITAL AVE SW
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-9301
Practice Address - Country:US
Practice Address - Phone:269-979-4936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRETSINGER CARE HOMES, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-03
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAM130065138311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home