Resolute Adult Living Facility

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AS410363656 Issued in MI

Legal business name

RESOLUTE ADULT LIVING FACILITY

Practice address

1414 Eastern Ave SE
Grand Rapids, MI 49507-2024

Phone

(616) 243-4696

Fax

(616) 243-4695

NPI assigned

Feb 18, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Tillman

Title

Licensee

Phone

(616) 243-4696

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487376000000",
    "number": "1144769506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 EASTERN AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072024",
            "telephone_number": "616-243-4696",
            "fax_number": "616-243-4695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 EASTERN AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495072024",
            "telephone_number": "616-243-4696",
            "fax_number": "616-243-4695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESOLUTE ADULT LIVING FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-18",
        "last_updated": "2017-02-18",
        "status": "A",
        "authorized_official_last_name": "TILLMAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "LICENSEE",
        "authorized_official_telephone_number": "616-243-4696"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AS410363656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Assisted Living Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.