National Provider Identifier Database

INDIAN TRAILS CAMP INC
Respite Care


Contact Information

INDIAN TRAILS CAMP, INC.
O-1859 LAKE MICHIGAN DR. NW
GRAND RAPIDS, MI49534
Phone: 616-677-5251
Fax: 616-677-2955
Website:
Specialty Taxonomy Code
* Respite Care 385H00000X
Day Training, Developmentally Disabled Services 251C00000X

* Indicates primary specialty

NPI Profile & details for INDIAN TRAILS CAMP, INC.

NPI Number 1972847184
Legal business name
LBN
INDIAN TRAILS CAMP, INC.
Authorized official TIMOTHY HILEMAN - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 11/15/2012
Last updated 11/15/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • MI License #: AC700200613
  • MI License #: SR700200220

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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