Healthcare Provider Details

I. General information

NPI: 1285785568
Provider Name (Legal Business Name): ABBYSHIRE PLACE HEALTH AND REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 BUCK RIDGE RD
BIDWELL OH
45614-9016
US

IV. Provider business mailing address

25500 MEADOWBROOK RD STE 230
NOVI MI
48375-1882
US

V. Phone/Fax

Practice location:
  • Phone: 740-446-7150
  • Fax: 740-446-1248
Mailing address:
  • Phone: 248-692-4355
  • Fax: 248-692-4356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number4588
License Number StateOH

VIII. Authorized Official

Name: MS. MARIANNE CONNER
Title or Position: VP FINANCE
Credential:
Phone: 248-277-5724