Healthcare Provider Details

I. General information

NPI: 1366066201
Provider Name (Legal Business Name): PRESBYTERIAN VILLAGE WESTLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2020
Last Update Date: 06/06/2020
Certification Date: 06/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32001 CHERRY HILL RD
WESTLAND MI
48186-7902
US

IV. Provider business mailing address

32001 CHERRY HILL RD
WESTLAND MI
48186-7902
US

V. Phone/Fax

Practice location:
  • Phone: 734-762-8885
  • Fax:
Mailing address:
  • Phone: 734-762-8885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELE R WHITE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 734-762-8885