Healthcare Provider Details

I. General information

NPI: 1255820890
Provider Name (Legal Business Name): WEST BLOOMFIELD SNF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 FARMINGTON RD
WEST BLOOMFIELD MI
48322-3220
US

IV. Provider business mailing address

620 DAVIS ST STE 200
EVANSTON IL
60201-4419
US

V. Phone/Fax

Practice location:
  • Phone: 248-661-1700
  • Fax:
Mailing address:
  • Phone:
  • 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: YAIR ZUCKERMAN
Title or Position: MANAGER
Credential:
Phone: 773-517-4777