Healthcare Provider Details

I. General information

NPI: 1548442247
Provider Name (Legal Business Name): COURTYARD MANOR OF FARMINGTON HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29750 FARMINGTON RD
FARMINGTON HILLS MI
48334-1922
US

IV. Provider business mailing address

3275 MARTIN RD SUITE 127
COMMERCE TWP MI
48390-1642
US

V. Phone/Fax

Practice location:
  • Phone: 248-539-0104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number StateMI

VIII. Authorized Official

Name: RONALD M PARADOWICZ
Title or Position: VICE PRESIDENT
Credential:
Phone: 248-926-2920