CRESTWOOD MANOR, LLC (NPI# 1316066616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316066616 |
| Entity Type | Organization |
| Organization Name | CRESTWOOD MANOR, LLC |
| Practice Address |
5078 Solvel St Kalamazoo MI 49004-1915 |
| Practice Telephone | 2692769371 |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GADO A ONGWELA (PRESIDENT) |
| Authorized Official Telephone | 2692769371 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | CRESTWOOD MANOR, LLC | 349 West 37th Street, New York, New York 10018 |
| Washington State Corporations | CRESTWOOD MANOR, LLC | 2120 Pacific St, Bellingham, WA 98229-5825 |
| Connecticut Business Registrations | CRESTWOOD MANOR, LLC | 90 Broad Street, Norwich, CT 06360 |
| Street Address |
5078 SOLVEL ST |
| City | KALAMAZOO |
| State | MI |
| Zip Code | 49004-1915 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134558455 | Brookside Care LLC | Assisted Living Facility | 5078 Solvel St, Kalamazoo, MI 49004-1915 | 2013-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386141018 | Jamie Kay Nevins | Nurse Practitioner | 4114 Mead St, Kalamazoo, MI 49004 | 2018-04-09 |
| 1396287231 | Joshua Tennyck | Specialist/Technologist | 1916 East G Ave, Parchment, MI 49004 | 2016-11-09 |
| 1861849960 | Karen Mcpherson | Rehabilitation Practitioner | 2826 Sonora St., Kalamazoo, MI 49004 | 2016-05-18 |
| 1972773182 | Interpretive Arts Counseling LLC | Counselor | 148 North Riverview Drive, Parchment, MI 49004 | 2008-03-04 |
| 1619071677 | Franklin Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 714 Shoppers Ln, Parchment, MI 49004-1118 | 2006-09-12 |
| 1396065132 | Michael Horosko | Pharmacist | 714 Shoppers Ln, Parchment, MI 49004-1118 | 2010-06-03 |
| 1144545625 | Paula Kay Crandell | Pharmacist | 714 Shoppers Ln, Parchment, MI 49004-1118 | 2010-03-29 |
| 1750606133 | Donald G Eichholz | Pharmacist | 714 Shoppers Ln, Parchment, MI 49004-1118 | 2010-03-29 |
| 1194040584 | Angela Renee Paska | Pharmacist | 714 Shoppers Ln, Parchment, MI 49004-1118 | 2010-03-29 |
| 1043534647 | Dawn Motakef | Pharmacist | 714 Shoppers Ln, Parchment, MI 49004-1118 | 2010-03-25 |
| Find all providers in zip 49004 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824913 | Pine Valley Assisted Living | Assisted Living Facility | 1155 N 26th St, Kalamazoo, MI 49048-9221 | 2019-07-25 |
| 1255528568 | Assisted Living Concepts Inc | Assisted Living Facility | 5364 Green Meadow Drive, Kalamazoo, MI 49009 | 2007-10-01 |
| 1346369717 | Docate Homes, LLC | Assisted Living Facility | 5297 Clato St, Kalamazoo, MI 49004-9588 | 2007-03-28 |
| 1730208067 | Golden Place Nurse Finders | Assisted Living Facility | 2901 Asbury Ave, Kalamazoo, MI 49048-1335 | 2007-03-28 |
| 1639638240 | Wycliffe Opiyo | Assisted Living Facility | 2901 Asbury Ave, Kalamazoo, MI 49048-1335 | 2019-03-14 |
| 1902037492 | Golden Care LLC | Assisted Living Facility | 2901 Asbury Ave, Kalamazoo, MI 49048-1335 | 2009-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518567890 | Mcap Holt Opco LLC | Assisted Living Facility | 4300 Keller Rd, Holt, MI 48842-1268 | 2020-10-27 |
| 1457959363 | Baruch Sls, Inc. | Assisted Living Facility | 3191 M 65, Hale, MI 48739-8512 | 2020-10-13 |
| 1215544739 | Baruch Sls, Inc. | Assisted Living Facility | 3100 Wyndham Dr, Flushing, MI 48433-2290 | 2020-09-29 |
| 1730796558 | Baruch Sls, Inc. | Assisted Living Facility | 130 Mary Ann St, Grayling, MI 49738-7037 | 2020-09-25 |
| 1649887472 | Baruch Sls, Inc. | Assisted Living Facility | 300 S Grand Ave, Leland, MI 49654-5052 | 2020-09-25 |
| 1013524834 | Baruch Sls, Inc. | Assisted Living Facility | 2801 Charlevoix Rd, Petoskey, MI 49770-9727 | 2020-09-25 |
| 1346857174 | Baruch Sls, Inc. | Assisted Living Facility | 1311 Southwestern Dr, Tecumseh, MI 49286-1233 | 2020-09-25 |
| 1427665439 | Baruch Sls, Inc. | Assisted Living Facility | 301 N Quick St, Blissfield, MI 49228-1051 | 2020-09-24 |
| 1295341956 | Comfort Home of Bloomfield Inc | Assisted Living Facility | 6372 Tutbury Ln, Troy, MI 48098-2151 | 2020-09-18 |
| 1306451679 | Traditions At Rivertown Park, LLC | Assisted Living Facility | 3555 Copper River Ave Sw, Wyoming, MI 49418-9791 | 2020-09-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.