Provider Demographics
NPI:1396016796
Name:NORTHVIEW CARE CORP.
Entity type:Organization
Organization Name:NORTHVIEW CARE CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-364-4690
Mailing Address - Street 1:3740 RICHTON AVE NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-2463
Mailing Address - Country:US
Mailing Address - Phone:616-364-4690
Mailing Address - Fax:616-364-4615
Practice Address - Street 1:3740 RICHTON AVE NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-2463
Practice Address - Country:US
Practice Address - Phone:616-364-4690
Practice Address - Fax:616-364-4615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAL410007147310400000X
MIAL410007164311500000X
MIAL410007146310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)