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General NPI Number Information
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NPI Number | 1922537364
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Entity Type | Organization
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Legal Business Name | LOURDES ALZHEIMER'S SPECIAL CARE
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2400 WATKINS LAKE RD
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City | WATERFORD
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State | MI
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Zip | 48328
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Country | US
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Telephone | 248-674-4732
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Fax | 248-618-6269
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Provider Business Mailing Address
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Address Line | 2400 WATKINS LAKE RD
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City | WATERFORD
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State | MI
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Zip | 48328-1427
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Country | US
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Telephone | 248-674-4732
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Fax | 248-618-6269
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Authorized Official
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Title or Position | DIRECTOR
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Name | CORI SHARRARD
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Credential | RN
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Telephone | 248-886-5102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | AL630007360
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License Number State | MI
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