Healthcare Provider Details
I. General information
NPI: 1982183042
Provider Name (Legal Business Name): ADRIAN MI SNF MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2018
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
130 SAND CREEK HWY
ADRIAN MI
49221-9129
US
IV. Provider business mailing address
7077 AV DU PARC SUITE 600
MONTREAL QUEBEC
H3N1X7
CA
V. Phone/Fax
- Phone: 517-265-6554
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
AARON
FRIEDMAN
Title or Position: MANAGER
Credential:
Phone: 514-777-3539