Healthcare Provider Details
I. General information
NPI: 1538218631
Provider Name (Legal Business Name): CHELSEA HEALTH CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2007
Last Update Date: 05/05/2022
Certification Date: 05/05/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25300 LAHSER RD
SOUTHFIELD MI
48034-5868
US
IV. Provider business mailing address
10503 CITATION DR STE 100
BRIGHTON MI
48116-6551
US
V. Phone/Fax
- Phone: 248-354-3222
- Fax: 248-354-2170
- Phone: 810-534-0150
- Fax: 810-534-0208
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | 634570 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 634570 |
| License Number State | MI |
VIII. Authorized Official
Name:
TODD
SANGSTER
Title or Position: CFO
Credential:
Phone: 810-534-0150