Healthcare Provider Details

I. General information

NPI: 1609953058
Provider Name (Legal Business Name): BORTZ HEALTH CARE OF YPSILANTI, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 S PROSPECT ST
YPSILANTI MI
48198-5616
US

IV. Provider business mailing address

11700 E 10 MILE RD
WARREN MI
48089-3903
US

V. Phone/Fax

Practice location:
  • Phone: 734-483-2220
  • Fax: 734-483-8972
Mailing address:
  • Phone: 586-759-5966
  • Fax: 586-759-8006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number814100
License Number StateMI

VIII. Authorized Official

Name: MR. DONALD JAMES BORTZ
Title or Position: PRESIDENT
Credential:
Phone: 586-759-5966