Provider Demographics
NPI:1205560315
Name:SKAGGS ASSISTED LIVING, LLC.
Entity type:Organization
Organization Name:SKAGGS ASSISTED LIVING, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SKAGGS
Authorized Official - Suffix:
Authorized Official - Credentials:BSN,RN
Authorized Official - Phone:517-617-4058
Mailing Address - Street 1:285 MCMAHON DR
Mailing Address - Street 2:
Mailing Address - City:BRONSON
Mailing Address - State:MI
Mailing Address - Zip Code:49028-9434
Mailing Address - Country:US
Mailing Address - Phone:517-617-4058
Mailing Address - Fax:517-858-1062
Practice Address - Street 1:285 MCMAHON DR
Practice Address - Street 2:
Practice Address - City:BRONSON
Practice Address - State:MI
Practice Address - Zip Code:49028-9434
Practice Address - Country:US
Practice Address - Phone:517-617-4058
Practice Address - Fax:517-858-1062
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SKAGGS ASSISTED LIVING, LLC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-13
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home