Cedar Knoll Care Center

Organization Active NPI Skilled Nursing Facility · Grass Lake, MI

NPI 1679568455 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1679568455
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
CEDAR KNOLL CARE CENTER
Practice address
9230 Cedar Knoll Dr
Grass Lake, MI 49240-9633
Phone
(517) 522-8471
Fax
(517) 522-3066
NPI assigned
Sep 16, 2005
Organization subpart
No

Authorized official

Name
Mr. John G Hupp
Title
Owner
Phone
(517) 522-8471

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Yes

Addresses

Primary practice location

9230 Cedar Knoll Dr
Grass Lake, MI 49240-9633

Mailing address

9230 Cedar Knoll Dr
Grass Lake, MI 49240-9633
Phone (517) 522-8471

Other identifiers

IdentifierTypeStateIssuer
3365195MedicaidMI

Other providers in Grass Lake, MI

All providers in Grass Lake, MI · Skilled Nursing Facility in Michigan

Sources for this page

Verify at the official NPI Registry.