Healthcare Provider Details

I. General information

NPI: 1225682958
Provider Name (Legal Business Name): CHERRY HILL OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38410 CHERRY HILL RD
WESTLAND MI
48185-3270
US

IV. Provider business mailing address

38410 CHERRY HILL RD
WESTLAND MI
48185-3270
US

V. Phone/Fax

Practice location:
  • Phone: 734-326-1200
  • 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: MARC SCHIOWITZ
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 848-757-0500