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General NPI Number Information
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NPI Number | 1982046983
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Entity Type | Organization
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Legal Business Name | LAKESHORE HEALTHCARE CRANBROOK CAMPUS INC
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Dates
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Enumeration Date | 07/19/2013
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Last Update Date | 07/19/2013
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Provider Practice Location Address
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Address Line | 5000 E 7 MILE RD
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City | DETROIT
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State | MI
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Zip | 48234-2261
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Country | US
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Telephone | 313-366-2900
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Fax | 313-366-5357
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Provider Business Mailing Address
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Address Line | 5000 E 7 MILE RD
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City | DETROIT
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State | MI
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Zip | 48234-2261
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Country | US
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Telephone | 313-366-2900
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Fax | 313-366-5357
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Authorized Official
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Title or Position | V P OPERATIONS
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Name | DEEPAK BHALLA
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Credential | PMP
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Telephone | 313-483-3905
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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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