Provider Demographics
NPI:1962839936
Name:COZY HILL A.F.C. L.L.C.
Entity Type:Organization
Organization Name:COZY HILL A.F.C. L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:H
Authorized Official - Last Name:STASSEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-521-7667
Mailing Address - Street 1:09441 44TH STREET
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49026
Mailing Address - Country:US
Mailing Address - Phone:269-521-7667
Mailing Address - Fax:269-521-7667
Practice Address - Street 1:09441 44TH STREET
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:MI
Practice Address - Zip Code:49026
Practice Address - Country:US
Practice Address - Phone:269-521-7667
Practice Address - Fax:269-521-7667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAF800274033310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility