NPIMap

Organization Active NPI

Baruch SLS, Inc.

  • Assisted Living Facility
  • Grant, MI
National Provider Identifier
1760607451
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AH620236786 Issued in MI
Legal business name
BARUCH SLS, INC.
Practice address
50 S Maple
Grant, MI 49327-9698
Phone
(231) 834-8202
Fax
(231) 834-8962
NPI assigned
Apr 16, 2007
Organization subpart
Yes
Parent organization
BARUCH SLS, INC.As reported in NPPES

Authorized official

NPPES NPI Registry
Name
Connie L Clauson
Title
VP Operations
Phone
(616) 285-0573

Corporate family (same tax ID) 19

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

View all 19

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0975379Fountain View Retirement Village50 S Maple, Grant, MI 49327Certificate of waiverJul 5, 2026

National Provider Directory

National Provider Directory
Tax ID family
Baruch SLS Inc (20 organizations share this tax ID)
Part of
Baruch SLS Inc

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AH620236786 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

50 S Maple
Grant, MI 49327-9698

Mailing address

3196 Kraft Ave SE Ste 203
Grand Rapids, MI 49512-2065
Phone (616) 285-0573

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
23D0975379OtherMICLIA

Other names 1

NPPES NPI Registry
  • Fountain View Retirement Village Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 25, 2020.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1760607451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3196 KRAFT AVE SE STE 203",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495122065",
            "telephone_number": "616-285-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S MAPLE",
            "city": "GRANT",
            "state": "MI",
            "postal_code": "493279698",
            "telephone_number": "231-834-8202",
            "fax_number": "231-834-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARUCH SLS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BARUCH SLS, INC.",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "CLAUSON",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "616-285-0573"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MI",
            "license": "AH620236786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "23D0975379",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fountain View Retirement Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fountain View Retirement Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.