Healthcare Provider Details

I. General information

NPI: 1912360595
Provider Name (Legal Business Name): RHEMA ARMADA OPERATING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22600 W MAIN ST
ARMADA MI
48005-3237
US

IV. Provider business mailing address

25800 NORTHWESTERN HWY SUITE 720
SOUTHFIELD MI
48075-8403
US

V. Phone/Fax

Practice location:
  • Phone: 586-784-5322
  • Fax:
Mailing address:
  • Phone: 248-569-8400
  • Fax: 248-569-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number50-406
License Number StateMI

VIII. Authorized Official

Name: MS. KELSEY HASTINGS
Title or Position: MANAGING MEMBER
Credential:
Phone: 248-569-8400