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General NPI Number Information
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NPI Number | 1396723508
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Entity Type | Organization
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Legal Business Name | EVANGELICAL HOMES OF MICHIGAN
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 440 W RUSSELL ST
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City | SALINE
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State | MI
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Zip | 48176-1184
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Country | US
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Telephone | 734-429-9401
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Fax | 734-429-0183
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Provider Business Mailing Address
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Address Line | 440 W RUSSELL ST
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City | SALINE
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State | MI
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Zip | 48176-1184
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Country | US
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Telephone | 734-429-9401
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Fax | 734-429-0183
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Authorized Official
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Title or Position | INTERIM CEO
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Name | JULIA WELLINGS
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Credential |
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Telephone | 734-295-9292
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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 | 814120
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License Number State | MI
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