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Organization
BOULEVARD MANOR L.L.C.
Active
Organization
BOULEVARD MANOR L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAHIM UDDIN (AUTHORIZED MEMBER)
(313) 579-2255
Entity
Organization
Contact information
Practice address
464 E GRAND BLVD, DETROIT, MI 48207-3637
(313) 579-2255
(313) 579-5756
Mailing address
2920 OAKWOOD BLVD, SUITE B, MELVINDALE, MI 48122-1244
(313) 579-2255
(313) 579-5756
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/01/2010
Last updated
04/20/2011
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