Individual provider · Type 1 NPI
Tyler Mark Ly
Adult Care Home Facility · Rockford, MI
NPI number
1487182960
Active
Practice location
5430 Polar Bear Ct NE
Rockford, MI 49341-7517
Fax (616) 883-6531
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Care Home Facility Primary | 311ZA0620X | AF410343519 (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 Rockford
About NPI 1487182960
Tyler Mark Ly's National Provider Identifier is 1487182960, issued on May 30, 2017. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Rockford, MI. The record was last updated on Jul 21, 2022.