Robert Gulley

Individual provider Active NPI Assisted Living Facility · Ishpeming, MI

NPI 1538054440 · NPPES record last updated Jun 11, 2025

Key facts

NPI
1538054440
Entity type
Individual (NPI type 1)
Primary specialty
Assisted Living Facility 310400000X
License
AF520379592 (MI)
Practice address
606 E High St
Ishpeming, MI 49849-1729
Phone
(906) 204-4378
NPI assigned
Jun 11, 2025
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AF520379592MIMDAssisted Living Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AF520379592 MI Yes

Addresses

Primary practice location

606 E High St
Ishpeming, MI 49849-1729

Mailing address

606 E High St
Ishpeming, MI 49849-1729
Phone (906) 204-4378

Other providers in Ishpeming, MI

All providers in Ishpeming, MI · Assisted Living Facility in Michigan

Sources for this page

Verify at the official NPI Registry.