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General NPI Number Information
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NPI Number | 1851415657
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Entity Type | Organization
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Legal Business Name | THE NORTH SOUTH PERSONA INC
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 22161 PARKLAWN ST
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City | OAK PARK
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State | MI
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Zip | 48237-2688
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Country | US
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Telephone | 248-545-7402
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Fax |
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Provider Business Mailing Address
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Address Line | 13420 BURTON ST
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City | OAK PARK
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State | MI
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Zip | 48237-1687
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Country | US
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Telephone | 248-506-9577
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Fax |
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Authorized Official
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Title or Position | LICENSEE
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Name | MS. PATRICIA F MULLIN
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Credential |
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Telephone | 248-506-9577
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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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