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General NPI Number Information
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NPI Number | 1508298852
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Entity Type | Organization
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Legal Business Name | ASHLEY COURT OF BRIGHTON INC.
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 08/08/2013
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Provider Practice Location Address
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Address Line | 7400 CHALLIS RD
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City | BRIGHTON
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State | MI
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Zip | 48116-9480
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Country | US
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Telephone | 734-622-0074
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Fax |
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Provider Business Mailing Address
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Address Line | 125 W ELLSWORTH RD
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City | ANN ARBOR
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State | MI
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Zip | 48108-2206
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Country | US
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Telephone | 734-622-0074
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. RUBIN CHANDOK
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Credential |
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Telephone | 734-622-0074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | AL470092982
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License Number State | MI
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