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General NPI Number Information
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NPI Number | 1407855695
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Entity Type | Organization
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Legal Business Name | PRESBYTERIAN VILLAGE REDFORD
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 25330 W 6 MILE RD
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City | REDFORD
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State | MI
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Zip | 48240-2105
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Country | US
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Telephone | 313-531-6874
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Fax | 313-541-6491
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Provider Business Mailing Address
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Address Line | 25330 W 6 MILE RD
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City | REDFORD
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State | MI
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Zip | 48240-2105
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Country | US
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Telephone | 313-531-6874
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Fax | 313-541-6491
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ROSE COLEMAN
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Credential | RN, NHA
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Telephone | 313-541-6418
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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 | 824250
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | MI
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