The Willows

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL110283726 Issued in MI

Legal business name

THE WILLOWS

Practice address

3440 Niles Rd
Saint Joseph, MI 49085-9601

Phone

(269) 428-0715

NPI assigned

Nov 17, 2009

Organization subpart

No

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

Authorized official

Name

Audrey Henriquez

Title

Administrator

Phone

(269) 428-0715

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

The Willows2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Willows

  • Assisted Living Facility
  • Saint Joseph, MI
  • NPI 1063740447
  NPD tax ID

Locations

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1598092298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 KRAFT AVE SE",
            "address_2": "SUITE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122078",
            "telephone_number": "616-464-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 NILES RD",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859601",
            "telephone_number": "269-428-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WILLOWS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-17",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "HENRIQUEZ",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "269-428-0715"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AL110283726",
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AL110283729",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D1102229",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teter Orthotics & Prosthetics, Inc
• The Benton Harbor-St. Joseph Young Men'S Christian Association
• The Pharmacy Shoppe, Inc.
• The Wholehearted Classoom
• The Willows
• Haley Thibeault
• Shelley Thibeault, NP
• Adam Thiesse, AT, ATC
• Cassie Thiesse, FNP-C
• Dihan Sameera Thilakaratne

• Assisted Living Facility in Saint Joseph, MI
• Providers in Saint Joseph, 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 Nov 17, 2009; 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.