Forest Glen Assisted Living, LLC
Organization Active NPI Clinical Medical Laboratory · Dowagiac, MI
NPI 1437467255 · NPPES record last updated Sep 14, 2010
Key facts
- NPI
- 1437467255
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- 23D1102204 (MI)
- Legal business name
- FOREST GLEN ASSISTED LIVING, LLC
- Practice address
- 29601 Amerihost Dr
Dowagiac, MI 49047-8320 - Phone
- (269) 782-5300
- NPI assigned
- Sep 14, 2010
- Organization subpart
- No
Authorized official
- Name
- Mr. Thomas Nobel
- Title
- President
- Phone
- (269) 782-5300
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D1102204 | Forest Glen Assisted Living | Certificate of waiver | Aug 10, 2026 |
National Provider Directory
Locations
29601 Amerihost Dr
Dowagiac, MI 49047
Phone (269) 782-5300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 23D1102204 | MI | Yes |
Addresses
Primary practice location
29601 Amerihost Dr
Dowagiac, MI 49047-8320
Mailing address
29601 Amerihost Dr
Dowagiac, MI 49047-8320
Phone (269) 782-5300
Other names
- Forest Glen Assisted Living - Laboratory
Other providers in Dowagiac, MI
- James Robert Eckman Jr.
- Jennifer Ervin
- Taylor Farmer
- Megan Lynne Foote
- Forest Glen Assisted Living
- Amber Gauthier
- Amanda Rose Gibson
- Jonathan Wade Gillesby
- Maddison Lee Golden
- Patricia Gordon
All providers in Dowagiac, MI · Clinical Medical Laboratory in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.