Provider Demographics
NPI:1609461821
Name:MOMENTOUS HEALTH AT BATTLE CREEK
Entity Type:Organization
Organization Name:MOMENTOUS HEALTH AT BATTLE CREEK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TENENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:917-613-5764
Mailing Address - Street 1:675 WAGNER DR
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-5721
Mailing Address - Country:US
Mailing Address - Phone:269-969-6244
Mailing Address - Fax:
Practice Address - Street 1:675 WAGNER DR
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-5721
Practice Address - Country:US
Practice Address - Phone:269-969-6244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility