# MEDILODGE OF MONROE, LLC

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

## Provider details

- **NPI number:** 1326013731
- **Authorized official:** MS. JANET E DALY RN,NHA (NURSING HOME ADMINISTRATOR)
- **Authorized official phone:** (734) 242-6282

## Contact information

- **Practice address:** 481 VILLAGE GREEN LN, MONROE, MI 48162-3367
- **Practice address phone:** (734) 242-6282
- **Practice address fax:** (734) 242-6491
- **Mailing address:** 481 VILLAGE GREEN LN, MONROE, MI 48162-3367
- **Mailing address phone:** (734) 242-6282
- **Mailing address fax:** (734) 242-6491

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 584040 | MI | Yes |

## Other

- **Enumeration date:** 02/20/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4216270 | — | MI |