# SE MICHIGAN SENIOR SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Baldwin House Lakeside I, Lakeside II & Oakland
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164194403
- **Authorized official:** JILLIAN J TISCH (AUTHORIZED PERSONNEL)
- **Authorized official phone:** (248) 545-0707

## Contact information

- **Practice address:** 1915 BALDWIN AVE, PONTIAC, MI 48340-1173
- **Practice address phone:** (248) 335-7020
- **Practice address fax:** (248) 335-0141
- **Mailing address:** 6905 TELEGRAPH RD STE 360, BLOOMFIELD HILLS, MI 48301-3189
- **Mailing address phone:** (248) 545-0707
- **Mailing address fax:** (248) 545-0270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332U00000X | Home Delivered Meals | — | NULL | Yes |
| 376J00000X | Homemaker | — | NULL | — |
| 376J00000X | Homemaker | — | — | — |

## Other

- **Enumeration date:** 10/05/2021
- **Last updated:** 10/18/2021