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NPI Code Detail

MEDICARE: HEARTLAND - GEORGIAN EAST OF GROSSE POINT MI, LLC

MEDICARE: HEARTLAND - GEORGIAN EAST OF GROSSE POINT MI, LLC
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
1314000000XSkilled Nursing Facility824075MI

General Provider Information

NPI Number : 1952341786
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTLAND - GEORGIAN EAST OF GROSSE POINT MI, LLC
Provider Business Mailing Address
First Line : 333 N SUMMIT ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-2615
Country : US
Telephone Number : 419-252-5500
Fax Number : 877-385-9446
Provider Business Practice Location Address
First Line : 21401 MACK AVE
Second Line :
City : GROSSE POINTE WOODS
State : MI
Zip : 48236-1048
Country : US
Telephone Number : 586-778-0800
Fax Number : 586-778-4688
Authorized Official
Title or Position : DIRECTOR
Name : MR. MARTIN D ALLEN
Credential :
Telephone Number : 419-252-5734
Provider Enumeration Date : 06/08/2006
Last Update Date : 04/21/2023

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Directions to “HEARTLAND - GEORGIAN EAST OF GROSSE POINT MI, LLC ” Practice Location

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