Dan McNeill

Individual provider Active NPI Assisted Living Facility (Behavioral Disturbances) · Gaines, MI

NPI 1720714645 · NPPES record last updated Jul 25, 2022

Key facts

NPI
1720714645
Entity type
Individual (NPI type 1)
Primary specialty
Assisted Living Facility (Behavioral Disturbances) 3104A0630X
License
AF250404622 (MI)
Practice address
110 Lansing St
Gaines, MI 48436-8938
Phone
(989) 271-6073
NPI assigned
Jul 25, 2022
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
AF250404622MIMDAssisted Living Facility (Behavioral Disturbances)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X AF250404622 MI Yes

Addresses

Primary practice location

110 Lansing St
Gaines, MI 48436-8938

Mailing address

110 Lansing St
Gaines, MI 48436-8938
Phone (989) 271-6073

Other providers in Gaines, MI

All providers in Gaines, MI · Assisted Living Facility (Behavioral Disturbances) in Michigan

Sources for this page

Verify at the official NPI Registry.