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NPI Code Detail

MEDICARE: WARREN GERIATRIC VILLAGE, INC

MEDICARE: WARREN GERIATRIC VILLAGE, INC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility504190MI

General Provider Information

NPI Number : 1396822771
Entity Type Code : Organization
Provider Name (Legal Business Name) : WARREN GERIATRIC VILLAGE, INC
Provider Business Mailing Address
First Line : 11700 E 10 MILE RD
Second Line :
City : WARREN
State : MI
Zip : 48089-3903
Country : US
Telephone Number : 586-759-5960
Fax Number : 586-759-5960
Provider Business Practice Location Address
First Line : 11700 E 10 MILE RD
Second Line :
City : WARREN
State : MI
Zip : 48089-3903
Country : US
Telephone Number : 586-759-5960
Fax Number : 586-759-3352
Authorized Official
Title or Position : PRESIDENT
Name : MR. DONALD JAMES BORTZ
Credential :
Telephone Number : 586-759-5966
Provider Enumeration Date : 11/01/2006
Last Update Date : 08/22/2020

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Directions to “WARREN GERIATRIC VILLAGE, INC ” Practice Location

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