Crestwood Manor, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CRESTWOOD MANOR, LLC

Practice address

5078 Solvel St
Kalamazoo, MI 49004-1915

Phone

(269) 276-9371

NPI assigned

Mar 28, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gado A Ongwela

Title

President

Phone

(269) 276-9371

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hagop P Ghazarian, DPM

  • Podiatrist
  • Mattawan, MI
  • NPI 1609820331
  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316066616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5078 SOLVEL ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490041915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5078 SOLVEL ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490041915",
            "telephone_number": "269-276-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ONGWELA",
        "authorized_official_first_name": "GADO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-276-9371",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy L Crawford
• Bernard Crawley, LPN
• Madison Suzanna Craze
• Susan M Creager, M.S.N.,A.P.R.N.. B.C
• John Creed, RBT
• Cynthia Ann Cretsinger, PA-C
• Khaleb Cretsinger
• Haleigh Cripe, PT, DPT
• Morgan Crippin
• Patricia K Criswell, LMSW

• Assisted Living Facility in Kalamazoo, MI
• Providers in Kalamazoo, 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 Aug 22, 2020; 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.