Basic Information
| Provider Information | |||||||||
| NPI: | 1851619332 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PADDINGTON HEALTHCARE OF MICHIGAN LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THE TIMBERS OF CASS COUNTY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 HAKES DR | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | NORTON SHORES | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494415574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317996870 | ||||||||
| FaxNumber: | 2317990250 | ||||||||
| Practice Location | |||||||||
| Address1: | 55432 COLBY STREET | ||||||||
| Address2: | |||||||||
| City: | DOWAGIAC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2697822828 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2010 | ||||||||
| LastUpdateDate: | 05/22/2019 | ||||||||
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| AuthorizedOfficialLastName: | LOCKHART | ||||||||
| AuthorizedOfficialFirstName: | DENNIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF ACCOUNTING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6144160600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.