Healthcare Provider Details
I. General information
NPI: 1861215113
Provider Name (Legal Business Name): WEXFORD SENIOR CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/05/2024
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
460 PEARL ST
CADILLAC MI
49601-2620
US
IV. Provider business mailing address
10503 CITATION DR
BRIGHTON MI
48116-6549
US
V. Phone/Fax
- Phone: 231-775-0101
- 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:
TODD
SANGSTER
Title or Position: CFO
Credential:
Phone: 810-534-0150