NPI 1063712586

Boulevard Manor L.L.C.

Organisation Skilled Nursing Facility Detroit, MI

Practice location

Address: 464 E Grand Blvd, Detroit, MI 48207-3637
Phone: (313) 579-2255
Fax: (313) 579-5756
Mailing address: 2920 Oakwood Blvd Suite B, Melvindale, MI 48122-1244

Authorised official

Name: Fahim Uddin
Title: Authorized Member
Phone: (313) 579-2255

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X

Other Skilled Nursing Facility providers in Michigan →

Registry record

NPI: 1063712586
Entity type: Organization
NPI issued: 1 Nov 2010
Record last updated: 20 Apr 2011

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.