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Organization
HAGGERTY ROAD OPCO LLC
Active
Organization
HAGGERTY ROAD OPCO LLC
Active
Other names
Medilodge of Haggerty Road
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE RANEL KIRK (DELEGATED OFFICIAL)
(417) 846-3521
Entity
Organization
Contact information
Practice address
105 N HAGGERTY RD, PLYMOUTH, MI 48170-1801
(734) 455-0510
(734) 455-7359
Mailing address
105 N HAGGERTY RD, PLYMOUTH, MI 48170-1801
(734) 455-0510
(734) 455-7359
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/25/2025
Last updated
10/23/2025
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