Healthcare Provider Details

I. General information

NPI: 1629734850
Provider Name (Legal Business Name): REGENCY AT TROY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 11/11/2021
Certification Date: 11/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2685 W MAPLE RD
TROY MI
48084
US

IV. Provider business mailing address

4000 TOWN CTR STE 2000
SOUTHFIELD MI
48075-1415
US

V. Phone/Fax

Practice location:
  • Phone: 248-262-2357
  • Fax:
Mailing address:
  • Phone: 248-262-2357
  • Fax:

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: TAMI L HUNT
Title or Position: PARALEGAL
Credential:
Phone: 248-262-2357