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General NPI Number Information
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NPI Number | 1386621241
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Entity Type | Organization
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Legal Business Name | DETROIT NUSRING CENTER LLC DBA IMPERIAL HEALTHCARE CENTRE
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Dates
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Enumeration Date | 12/30/2005
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 26505 POWERS AVE
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-1327
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Country | US
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Telephone | 313-291-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 26505 POWERS AVE
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-1327
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Country | US
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Telephone | 313-291-6200
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MARCELLA GRAF
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Credential |
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Telephone | 224-470-2044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 824012
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License Number State | MI
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