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General NPI Number Information
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NPI Number | 1548528656
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Entity Type | Organization
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Legal Business Name | ST. MARIE'S
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 24555 SOUTHFIELD RD STE 100
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2788
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Country | US
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Telephone | 248-809-3795
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Fax |
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Provider Business Mailing Address
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Address Line | 24555 SOUTHFIELD RD STE 100
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2788
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Country | US
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Telephone | 248-809-3795
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MS. MELVIE BERKERY
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Credential |
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Telephone | 248-809-3795
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | MI
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