Provider Demographics
NPI:1689004921
Name:NICHE AGING CENTER
Entity type:Organization
Organization Name:NICHE AGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:NAHIKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:989-684-2273
Mailing Address - Street 1:3405 E MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2825
Mailing Address - Country:US
Mailing Address - Phone:989-684-2273
Mailing Address - Fax:
Practice Address - Street 1:3405 E MIDLAND RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2825
Practice Address - Country:US
Practice Address - Phone:989-684-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-23
Last Update Date:2013-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS0903098213104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances