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General NPI Number Information
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NPI Number | 1720236920
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Entity Type | Organization
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Legal Business Name | HEARTLAND OF WEST BLOOMFIELD MI LLC
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 6950 FARMINGTON RD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3220
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Country | US
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Telephone | 248-661-1700
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Fax | 248-661-7834
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Provider Business Mailing Address
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Address Line | 333 N SUMMIT ST ATTN BARRY A LAZARUS
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City | TOLEDO
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State | OH
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Zip | 43604-1531
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Country | US
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Telephone | 419-252-5541
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Fax | 419-254-5494
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Authorized Official
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Title or Position | VICE PRESIDENT-REIMBURSEMENT
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Name | MR. BARRY A LAZARUS
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Credential |
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Telephone | 419-252-5518
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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 |
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