Provider Demographics
NPI:1558771725
Name:RETIREMENT LIVING MANAGEMENT OF CADILLAC, L.L.C
Entity Type:Organization
Organization Name:RETIREMENT LIVING MANAGEMENT OF CADILLAC, L.L.C
Other - Org Name:GREEN ACRE CADILLAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAREASE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAUDET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-775-5300
Mailing Address - Street 1:235 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-2615
Mailing Address - Country:US
Mailing Address - Phone:231-775-5300
Mailing Address - Fax:231-775-5040
Practice Address - Street 1:235 PEARL ST
Practice Address - Street 2:
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-2615
Practice Address - Country:US
Practice Address - Phone:231-775-5300
Practice Address - Fax:231-775-5040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAL830244420311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility