Provider Demographics
NPI:1124020466
Name:ZEELAND SKILLED NURSING FACILITY INC
Entity type:Organization
Organization Name:ZEELAND SKILLED NURSING FACILITY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-846-3521
Mailing Address - Street 1:285 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-1297
Mailing Address - Country:US
Mailing Address - Phone:616-772-4641
Mailing Address - Fax:616-772-4641
Practice Address - Street 1:285 N STATE ST
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1297
Practice Address - Country:US
Practice Address - Phone:616-772-4641
Practice Address - Fax:616-772-4641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1124020466Medicaid
MI235347Medicare ID - Type Unspecified