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NPI Code Detail

MEDICARE: PERSONALIZED NURSING LIGHT HOUSE INC

MEDICARE: PERSONALIZED NURSING LIGHT HOUSE INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251T00000XPACE Provider Organization631359MI

General Provider Information

NPI Number : 1346684420
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERSONALIZED NURSING LIGHT HOUSE INC
Provider Business Mailing Address
First Line : 23133 ORCHARD LAKE RD
Second Line : STE 203
City : FARMINGTON HILLS
State : MI
Zip : 48336-3268
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 23133 ORCHARD LAKE RD
Second Line : STE 203
City : FARMINGTON HILLS
State : MI
Zip : 48336-3268
Country : US
Telephone Number : 248-615-1891
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. JOSEPH PALIWODA
Credential :
Telephone Number : 734-451-7800
Provider Enumeration Date : 04/19/2013
Last Update Date : 04/19/2013

Similar Medicare Providers

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Practice Location Address:
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FARMINGTON HILLS, MI
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1346210317 — WILLIAM R RAMINICK D.O.
Practice Location Address:
23133 ORCHARD LAKE RD STE 200
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1962472423 — MICHAEL A BIEDERMAN D.O.
Practice Location Address:
23133 ORCHARD LAKE RD STE 200
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1457563488 — MARIQUIT DUMAGUIN SENDELBACH D.O.
Practice Location Address:
23133 ORCHARD LAKE RD STE 200
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1548491129 — DR. KATIE HILL MACFARLANE D.O.
Practice Location Address:
23133 ORCHARD LAKE RD STE 200
FARMINGTON HILLS, MI
48336-3268
Practice Phone: 248-579-9220
Practice Fax: 248-471-9978

Directions to “PERSONALIZED NURSING LIGHT HOUSE INC ” Practice Location

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