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General NPI Number Information
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NPI Number | 1669479895
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Entity Type | Organization
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Legal Business Name | ST. MARY'S ACQUISITION COMPANY INC
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 08/15/2019
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Provider Practice Location Address
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Address Line | 22700 GREATER MACK AVENUE
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City | ST CLAIR SHORES
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State | MI
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Zip | 48080-1917
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Country | US
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Telephone | 586-443-4910
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 TOWN CTR STE 2000
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City | SOUTHFIELD
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State | MI
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Zip | 48075-1415
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Country | US
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Telephone | 248-262-2357
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Fax | 586-772-6608
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Authorized Official
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Title or Position | CEO
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Name | MR. MOHAMMAD ASHRAF QAZI
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Credential |
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Telephone | 248-386-0300
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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 |
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License Number State |
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