Provider Demographics
NPI:1942795034
Name:PALS PLACE, LLC
Entity Type:Organization
Organization Name:PALS PLACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-938-0018
Mailing Address - Street 1:5336 E COURT ST S
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1944
Mailing Address - Country:US
Mailing Address - Phone:810-820-6348
Mailing Address - Fax:
Practice Address - Street 1:5336 E COURT ST S
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1944
Practice Address - Country:US
Practice Address - Phone:810-820-6348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home