# HERITAGE MANOR NURSING & REHAB CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164772646
- **Authorized official:** FAHIM UDDIN (AUTHORIZED MEMBER)
- **Authorized official phone:** (248) 593-1990

## Contact information

- **Practice address:** 9500 GRAND RIVER AVE, DETROIT, MI 48204-2132
- **Practice address phone:** (313) 491-7920
- **Practice address fax:** (313) 491-0510
- **Mailing address:** 30700 TELEGRAPH RD, SUITE 2504, BINGHAM FARMS, MI 48025-4524
- **Mailing address phone:** (248) 593-1990
- **Mailing address fax:** (248) 593-9120

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | MI | Yes |

## Other

- **Enumeration date:** 09/12/2012
- **Last updated:** 01/17/2013