Provider Demographics
NPI:1477166924
Name:WHISPERING PINES 2
Entity Type:Organization
Organization Name:WHISPERING PINES 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DORTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-238-9715
Mailing Address - Street 1:1878 SOULES RD
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:MI
Mailing Address - Zip Code:49705-9717
Mailing Address - Country:US
Mailing Address - Phone:231-420-5288
Mailing Address - Fax:
Practice Address - Street 1:1878 SOULES RD
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:MI
Practice Address - Zip Code:49705-9717
Practice Address - Country:US
Practice Address - Phone:231-238-9715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty