Healthcare Provider Details

I. General information

NPI: 1225035561
Provider Name (Legal Business Name): ST ANTHONY ACQUISITION COMPANY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31830 RYAN RD
WARREN MI
48092-3767
US

IV. Provider business mailing address

31830 RYAN RD
WARREN MI
48092-3767
US

V. Phone/Fax

Practice location:
  • Phone: 586-977-6700
  • Fax: 586-977-6727
Mailing address:
  • Phone: 586-977-6700
  • Fax: 586-977-6727

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: MR. MOHAMMAD ASHRAF QAZI
Title or Position: CEO
Credential:
Phone: 248-386-0300