Healthcare Provider Details

I. General information

NPI: 1336188101
Provider Name (Legal Business Name): RD SENIOR CARE SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 UNION LAKE RD
WHITE LAKE MI
48386-4348
US

IV. Provider business mailing address

PO BOX 151
UNION LAKE MI
48387-0151
US

V. Phone/Fax

Practice location:
  • Phone: 248-363-4143
  • Fax: 248-363-2160
Mailing address:
  • Phone: 248-363-4143
  • Fax: 248-363-2160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: M MICHELE HEIDENREICH
Title or Position: PRESIDENT
Credential: PAC
Phone: 248-363-4143