NPI 1003887662

Medilodge of Plymouth, INC.

Organisation Skilled Nursing Facility Plymouth, MI

Practice location

Address: 395 W Ann Arbor Trl, Plymouth, MI 48170-1641
Phone: (734) 453-3983
Fax: (734) 414-8231

Authorised official

Name: Kathleen Denean
Title: Chief Executive Officer
Phone: (586) 752-5008

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 824320 (MI)

Other Skilled Nursing Facility providers in Michigan →

Registry record

NPI: 1003887662
Entity type: Organization
NPI issued: 31 Jan 2006
Record last updated: 16 Jul 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.