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General NPI Number Information
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NPI Number | 1902814163
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Entity Type | Organization
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Legal Business Name | BALMORAL, INC.
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 06/05/2008
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Provider Practice Location Address
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Address Line | 5500 FORT ST
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City | TRENTON
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State | MI
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Zip | 48183-4602
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Country | US
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Telephone | 734-671-3500
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Fax | 734-671-3769
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Provider Business Mailing Address
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Address Line | 5500 FORT ST
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City | TRENTON
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State | MI
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Zip | 48183-4602
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Country | US
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Telephone | 734-671-3500
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Fax | 734-671-3769
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Authorized Official
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Title or Position | CFO
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Name | MR. DOUG WELDAY
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Credential |
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Telephone | 313-253-6017
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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 | 824022
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License Number State | MI
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