Provider Demographics
NPI:1497988810
Name:INDIAN SPRINGS FARM
Entity Type:Organization
Organization Name:INDIAN SPRINGS FARM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARTOUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-629-3439
Mailing Address - Street 1:9521 CONDIT RD
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:MI
Mailing Address - Zip Code:49224-9720
Mailing Address - Country:US
Mailing Address - Phone:517-629-3439
Mailing Address - Fax:
Practice Address - Street 1:9521 CONDIT RD
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:MI
Practice Address - Zip Code:49224-9720
Practice Address - Country:US
Practice Address - Phone:517-629-3439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAFC130000965310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility