Healthcare Provider Details

I. General information

NPI: 1295071991
Provider Name (Legal Business Name): OAKRIDGE MANOR NURSING & REHAB CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2012
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3161 HILTON RD
FERNDALE MI
48220-1038
US

IV. Provider business mailing address

30700 TELEGRAPH RD SUITE 2504
BINGHAM FARMS MI
48025-4524
US

V. Phone/Fax

Practice location:
  • Phone: 248-547-6227
  • Fax: 248-399-0190
Mailing address:
  • Phone: 248-593-1990
  • Fax: 248-593-9120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: FAHIM UDDIN
Title or Position: OWNER
Credential:
Phone: 313-549-7708