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General NPI Number Information
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NPI Number | 1801962097
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Entity Type | Organization
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Legal Business Name | CLIFFSIDE COMPANY L L C
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 3905 LORRAINE PATH
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-8630
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Country | US
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Telephone | 269-428-1111
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Fax | 269-556-9684
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Provider Business Mailing Address
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Address Line | 910 S WASHINGTON AVE
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City | ROYAL OAK
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State | MI
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Zip | 48067-3216
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Country | US
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Telephone | 248-543-7300
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Fax | 248-399-5300
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Authorized Official
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Title or Position | OWNER
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Name | DAVID J HARTMAN
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Credential |
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Telephone | 773-259-1600
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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 | 1070000420
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 114184
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License Number State | MI
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