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General NPI Number Information
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NPI Number | 1891792032
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Entity Type | Organization
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Legal Business Name | CAMELOT HALL ACQUISITION COMPANY INC
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 03/26/2020
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Provider Practice Location Address
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Address Line | 2209 N NEWBURGH RD
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City | WESTLAND
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State | MI
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Zip | 48185-3373
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Country | US
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Telephone | 734-522-1444
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Fax | 734-522-4690
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Provider Business Mailing Address
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Address Line | 2209 N NEWBURGH RD
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City | WESTLAND
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State | MI
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Zip | 48185-3373
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Country | US
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Telephone | 734-522-1444
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Fax | 734-522-4690
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Authorized Official
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Title or Position | CEO
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Name | MR. MOHAMMAD A. 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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