Provider Demographics
NPI:1326507914
Name:MICHIGAN SENIOR CARE LIVING, LLC
Entity Type:Organization
Organization Name:MICHIGAN SENIOR CARE LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMCHANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MISHRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-359-5606
Mailing Address - Street 1:1 WOODROW CT
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3151
Mailing Address - Country:US
Mailing Address - Phone:269-359-5606
Mailing Address - Fax:877-265-1856
Practice Address - Street 1:261 BEACHFIELD DR
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4641
Practice Address - Country:US
Practice Address - Phone:269-964-4580
Practice Address - Fax:877-265-1856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home