Healthcare Provider Details

I. General information

NPI: 1174502538
Provider Name (Legal Business Name): FATHER MURRAY NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8444 ENGLEMAN
CENTER LINE MI
48015
US

IV. Provider business mailing address

28000 DEQUINDRE
WARREN MI
48092
US

V. Phone/Fax

Practice location:
  • Phone: 586-755-2400
  • Fax: 586-755-8006
Mailing address:
  • Phone: 586-753-0310
  • Fax: 586-753-1276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberBHS 504210
License Number StateMI

VIII. Authorized Official

Name: TOMASINE F MARX
Title or Position: VICE PRESIDENT FINANCE
Credential:
Phone: 586-753-0310