# LAKESHORE HEALTHCARE ELMWOOD CAMPUS 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:** 1285076273
- **Authorized official:** DEEPAK BHALLA PMP (V P OPERATIONS)
- **Authorized official phone:** (313) 483-3905

## Contact information

- **Practice address:** 1881 E GRAND BLVD, DETROIT, MI 48211-3041
- **Practice address phone:** (313) 922-1600
- **Practice address fax:** (313) 922-4756
- **Mailing address:** 1881 E GRAND BLVD, DETROIT, MI 48211-3041
- **Mailing address phone:** (313) 922-1600
- **Mailing address fax:** (313) 922-4756

## Taxonomy

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

## Other

- **Enumeration date:** 07/19/2013
- **Last updated:** 07/19/2013