MEDICARE: RD SENIOR CARE SERVICES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	2084P0805X	Geriatric Psychiatry Physician
2	363AM0700X	Medical Physician Assistant
3	103TC0700X	Clinical Psychologist
4	364SG0600X	Gerontology Clinical Nurse Specialist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0F31774	OTHER	MI	BCBSM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336188101
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RD SENIOR CARE SERVICES PC

Provider Business Mailing Address
First Line	:	PO BOX 151
Second Line	:
City	:	UNION LAKE
State	:	MI
Zip	:	48387-0151
Country	:	US
Telephone Number	:	248-363-4143
Fax Number	:	248-363-2160

Provider Business Practice Location Address
First Line	:	1157 UNION LAKE RD
Second Line	:
City	:	WHITE LAKE
State	:	MI
Zip	:	48386-4348
Country	:	US
Telephone Number	:	248-363-4143
Fax Number	:	248-363-2160

Authorized Official
Title or Position	:	PRESIDENT
Name	:	M MICHELE HEIDENREICH
Credential	:	PAC
Telephone Number	:	248-363-4143

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	09/11/2025

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