Provider Demographics
NPI:1710115316
Name:FRANCISCAN LIFE CENTER NETWORK, INC., DBA, FRANCISCAN LIFE PROCESS CEN
Entity Type:Organization
Organization Name:FRANCISCAN LIFE CENTER NETWORK, INC., DBA, FRANCISCAN LIFE PROCESS CEN
Other - Org Name:FRANCISCAN LIFE PROCESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SISTER COLLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NAGLE, F.S.E.
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:616-897-7842
Mailing Address - Street 1:11650 DOWNES ST NE
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49331-9489
Mailing Address - Country:US
Mailing Address - Phone:616-897-7842
Mailing Address - Fax:616-897-7054
Practice Address - Street 1:11650 DOWNES ST NE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MI
Practice Address - Zip Code:49331-9489
Practice Address - Country:US
Practice Address - Phone:616-897-7842
Practice Address - Fax:616-897-7054
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI011289252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency