NPI 1962287318

West Village Sil LLC

Organisation PACE Provider Organization Detroit, MI

Practice location

Address: 12052 Mendota St, Detroit, MI 48204
Phone: (313) 258-6325
Mailing address: 12060 Mendota St, Detroit, MI 48204-1826

Authorised official

Name: Carla Renee West
Title: President
Phone: (313) 258-6325

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Michigan →

Registry record

NPI: 1962287318
Entity type: Organization
NPI issued: 25 Aug 2023
Record last updated: 25 Aug 2023

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.