Healthcare Provider Details

I. General information

NPI: 1063586923
Provider Name (Legal Business Name): APPLEWOOD NURSING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18500 VAN HORN RD
WOODHAVEN MI
48183-3803
US

IV. Provider business mailing address

910 S WASHINGTON AVE
ROYAL OAK MI
48067-3216
US

V. Phone/Fax

Practice location:
  • Phone: 734-676-7575
  • Fax: 734-692-0039
Mailing address:
  • Phone: 248-543-7300
  • Fax: 248-399-5300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number82-4510
License Number StateMI

VIII. Authorized Official

Name: MS. KIMBERLY M. TACKETT
Title or Position: PRESIDENT
Credential:
Phone: 248-543-7300