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General NPI Number Information
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NPI Number | 1639173214
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Entity Type | Organization
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Legal Business Name | LUTHERAN HOMES OF MICHIGAN INC
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 09/14/2007
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Provider Practice Location Address
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Address Line | 1236 S MONROE STREET HOME FOR THE AGED
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City | MONROE
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State | MI
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Zip | 48161-3998
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Country | US
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Telephone | 734-241-9533
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Fax | 734-241-9108
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Provider Business Mailing Address
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Address Line | 9710 JUNCTION RD PO BOX 329
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City | FRANKENMUTH
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State | MI
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Zip | 48734-0329
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Country | US
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Telephone | 989-652-3470
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Fax | 989-652-3480
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. MICHAEL G CORBY
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Credential |
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Telephone | 989-652-3470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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