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General NPI Number Information
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NPI Number | 1629269378
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Entity Type | Organization
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Legal Business Name | LUTHERAN SOCIAL SERVICES OF MICHIGAN
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 2000 32ND ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-7910
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Country | US
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Telephone | 616-452-6084
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Fax | 616-452-8525
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Provider Business Mailing Address
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Address Line | 8131 E JEFFERSON AVE
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City | DETROIT
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State | MI
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Zip | 48214-2610
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Country | US
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Telephone | 313-823-7700
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Fax | 313-823-9604
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Authorized Official
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Title or Position | CFO
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Name | LOUELLEN MCGRATH
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Credential |
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Telephone | 313-823-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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