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PROF. THERA NICHOLS
NPI 1962291666
Assisted Living Facility in Grass Lake, MI

Active since May 01, 2025
3775 WOLF LAKE RD, GRASS LAKE, MI 49240(517) 522-5013(517) 522-5359 Get Directions Write a Review

NPPES record last updated: May 1, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Prof. Thera Nichols NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROF. THERA NICHOLS (NPI 1962291666) is an individual assisted living facility provider in Grass Lake, Michigan, licensed in Michigan (380418074) and active in the NPI registry since May 2025.

NPPES Registry Identity

NPI1962291666
Entity TypeIndividualFemale
Primary Taxonomy310400000X
Provider Legal NamePROF. THERA NICHOLS
Location Address3775 WOLF LAKE RDGrass Lake, MI 49240-9490
Mailing Address3775 Wolf Lake RdGrass Lake, MI 49240-9490 · (517) 522-5013 · Fax (517) 522-5359
Phone(517) 522-5013
Fax(517) 522-5359
Sole ProprietorYes
Enumeration DateMay 1, 2025
NPPES CertifiedMay 1, 2025
✔ NPI 1962291666 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MI · 380418074
Definition
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.
3775 WOLF LAKE RD, Grass Lake, MI 49240
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thera Nichols's NPI number?

The NPI number for Thera Nichols is 1962291666. It was assigned to this individual provider in the NPPES registry on May 1, 2025.

Where is Thera Nichols located?

Thera Nichols practices at 3775 Wolf Lake Rd, Grass Lake, MI 49240. The listed phone number is (517) 522-5013.

What is Thera Nichols's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Thera Nichols was last updated on May 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.