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General NPI Number Information
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NPI Number | 1982007662
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Entity Type | Organization
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Legal Business Name | FAIRWAY SENIOR SERVICES
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Dates
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Enumeration Date | 10/08/2014
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 29140 MURRAY CRESCENT DR
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City | SOUTHFIELD
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State | MI
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Zip | 48076-5246
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Country | US
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Telephone | 248-281-6910
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Fax |
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Provider Business Mailing Address
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Address Line | 17386 MAPLE HILL DR
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City | NORTHVILLE
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State | MI
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Zip | 48168-3216
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Country | US
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Telephone | 313-205-8040
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DAVID P TURNER
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Credential |
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Telephone | 313-205-8040
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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 |
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