Provider Demographics
NPI:1922432699
Name:ROBBINSWOOD OPERATING COMPANY
Entity Type:Organization
Organization Name:ROBBINSWOOD OPERATING COMPANY
Other - Org Name:ROBBINSWOOD ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:TRYGSTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-842-1900
Mailing Address - Street 1:601 WATERSTONE DR
Mailing Address - Street 2:
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49441-6504
Mailing Address - Country:US
Mailing Address - Phone:616-842-1900
Mailing Address - Fax:
Practice Address - Street 1:1125 ROBBINS RD
Practice Address - Street 2:
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417
Practice Address - Country:US
Practice Address - Phone:616-842-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAH700319383310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility