Provider Demographics
NPI:1891830295
Name:SUNNY ACRES NURSING CENTER, INC
Entity type:Organization
Organization Name:SUNNY ACRES NURSING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:989-269-9138
Mailing Address - Street 1:2762 PIGEON RD
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413-9738
Mailing Address - Country:US
Mailing Address - Phone:989-269-9138
Mailing Address - Fax:989-269-9168
Practice Address - Street 1:2762 PIGEON RD
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-9738
Practice Address - Country:US
Practice Address - Phone:989-269-9138
Practice Address - Fax:989-269-9168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI324020313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI324020Medicaid