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Traditions At Rivertown Park, Llc

NPI Registration Record

Provider / OrganizationNPIDate Certified
TRADITIONS AT RIVERTOWN PARK, LLC13064516792020-09-13
Other Names:
Entity TypeOrganization
Provider OrganizationTRADITIONS AT RIVERTOWN PARK, LLC
Practice Office Address3555 COPPER RIVER AVE SW
WYOMING, MI US
Practice Office Telephone6162582727
Practice Office Fax6162582717
Mailing Address3555 COPPER RIVER AVE SW
WYOMING, MI 494189791 US
Business Telephone6162582727
Business Fax6162582717
Authorized OfficialJUDY AMIANO, PRESIDENT AND C
3313185200
HPT Codes
CodeLicense NoState
310400000X PRIMARY
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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