# PARKSIDE ESTATES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Parkside Estates Senior Residence
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669899910
- **Authorized official:** MR. GREGORY SCOTT RICHARDS (ADMINSTRATOR)
- **Authorized official phone:** (734) 692-0877

## Contact information

- **Practice address:** 28860 COLEMAN DR, GROSSE ILE, MI 48138-2053
- **Practice address phone:** (734) 692-0877
- **Mailing address:** 2211 PARKSIDE ST, TRENTON, MI 48183-2512
- **Mailing address phone:** (734) 692-0877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | AS820313332 | MI | Yes |

## Other

- **Enumeration date:** 03/25/2014
- **Last updated:** 03/25/2014