# THE MEDILODGE GROUP, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1275713463
- **Authorized official:** MRS. KATHLEEN DENEAN (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (586) 752-5008

## Contact information

- **Practice address:** 64500 VAN DYKE RD, WASHINGTON, MI 48095-2583
- **Practice address phone:** (586) 752-5008
- **Practice address fax:** (586) 752-7609
- **Mailing address:** 64500 VAN DYKE RD, WASHINGTON, MI 48095-2583
- **Mailing address phone:** (586) 752-5008
- **Mailing address fax:** (586) 752-7609

## Taxonomy

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

## Other

- **Enumeration date:** 11/06/2007
- **Last updated:** 05/01/2008