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Organization
LITTLE ROCK BAPTIST CHARITY CARE CENTER, INC.
Active
Organization
LITTLE ROCK BAPTIST CHARITY CARE CENTER, INC.
Active
Other names
Lakeshore Healthcare Skilled Nursing & Specialty Care - Woodward Campu
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPAK BHALLA (EXEC. V.P. OPERATIONS)
(313) 483-3905
Entity
Organization
Contact information
Practice address
9146 WOODWARD AVENUE, DETROIT, MI 48202-1612
(313) 875-1263
(313) 875-5842
Mailing address
9146 WOODWARD AVENUE, DETROIT, MI 48202-1612
(313) 875-1263
(313) 875-5842
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
834930
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2151069
—
MI
Enumeration date
09/07/2005
Last updated
10/17/2012
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