Healthcare Provider Details

I. General information

NPI: 1366633018
Provider Name (Legal Business Name): SAMARITAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 PEARL ST
CADILLAC MI
49601-2620
US

IV. Provider business mailing address

8131 E JEFFERSON AVE
DETROIT MI
48214-2610
US

V. Phone/Fax

Practice location:
  • Phone: 231-775-0101
  • Fax: 231-775-1390
Mailing address:
  • Phone: 313-823-7700
  • Fax: 313-823-9604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number844020
License Number StateMI

VIII. Authorized Official

Name: BRIDGETTE ZAPPACOSTA
Title or Position: CFO
Credential:
Phone: 313-308-2768