MEDICARE: MOROUN NURSING CENTER OF DETROIT, LLC

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
1	314000000X	Skilled Nursing Facility	834650	MI

General Provider Information

NPI Number	:	1770812281
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOROUN NURSING CENTER OF DETROIT, LLC

Provider Business Mailing Address
First Line	:	8045 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48214-2627
Country	:	US
Telephone Number	:	313-821-3525
Fax Number	:	313-821-3544

Provider Business Practice Location Address
First Line	:	8045 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48214-2627
Country	:	US
Telephone Number	:	313-821-3525
Fax Number	:	313-821-3544

Authorized Official
Title or Position	:	CFO
Name	:	MARCELLA GRAF
Credential	:
Telephone Number	:	224-470-2044

Provider Enumeration Date	:	12/11/2009
Last Update Date	:	11/04/2025

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