Provider Demographics
NPI:1851536171
Name:FOX HOLES HOME, INC.
Entity Type:Organization
Organization Name:FOX HOLES HOME, INC.
Other - Org Name:BECK'N CALL HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDENBOSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-795-5350
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-0111
Mailing Address - Country:US
Mailing Address - Phone:269-795-5350
Mailing Address - Fax:
Practice Address - Street 1:8200 SHAW LAKE RD
Practice Address - Street 2:
Practice Address - City:MIDDLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:49333-8548
Practice Address - Country:US
Practice Address - Phone:269-795-5350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility