Individual provider · Type 1 NPI

Michael D. Wagner

Adult Care Home Facility · Grand Rapids, MI

NPI number 1336655034 Active

Practice location

807 Pine Ave NW
Grand Rapids, MI 49504-4340

Call (616) 776-7094 Map

Fax (616) 776-7094

Specialties and licenses

TaxonomyCodeLicense
Adult Care Home Facility Primary 311ZA0620XAF410387497 (MI)

Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

Other adult care home facility providers in Grand Rapids

See all in Grand Rapids →

About NPI 1336655034

Michael D. Wagner's National Provider Identifier is 1336655034, issued on Dec 18, 2017. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Grand Rapids, MI. The record was last updated on Dec 18, 2017.