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Organization
IHS ACQUISITION NO. 111, INC.
Active
Organization
IHS ACQUISITION NO. 111, INC.
Active
Other names
Clarkston Specialty Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MAGGIE CANNY (PRESIDENT)
(248) 674-0903
Entity
Organization
Contact information
Practice address
4800 CLINTONVILLE RD, CLARKSTON, MI 48346-4297
(248) 674-0903
(248) 674-3431
Mailing address
930 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4163588
—
MI
Enumeration date
10/07/2006
Last updated
12/20/2007
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