Individual provider · Type 1 NPI
Thera Nichols
Assisted Living Facility · Grass Lake, MI
NPI number
1962291666
Active
Practice location
3775 Wolf Lake Rd
Grass Lake, MI 49240-9490
Fax (517) 522-5359
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Assisted Living Facility Primary | 310400000X | 380418074 (MI) |
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.
About NPI 1962291666
Thera Nichols's National Provider Identifier is 1962291666, issued on May 1, 2025. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Grass Lake, MI. The record was last updated on May 1, 2025.