Provider Demographics
NPI:1427557057
Name:R AND R AFC HOME INC
Entity Type:Organization
Organization Name:R AND R AFC HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKENDESHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-837-0894
Mailing Address - Street 1:105 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:MI
Mailing Address - Zip Code:48471-1309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:MI
Practice Address - Zip Code:48471-1309
Practice Address - Country:US
Practice Address - Phone:810-648-3326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-09
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home