# ST JOHN SENIOR COMMUNITY

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

## Provider details

- **NPI number:** 1700865169
- **Authorized official:** TOMASINE F MARX (VICE PRESIDENT FINANCE)
- **Authorized official phone:** (586) 753-0310

## Contact information

- **Practice address:** 18300 E WARREN, DETROIT, MI 48224
- **Practice address phone:** (313) 343-8000
- **Practice address fax:** (313) 343-8959
- **Mailing address:** 28000 DEQUINDRE, WARREN, MI 48092
- **Mailing address phone:** (586) 753-0310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | BHS834032 | MI | Yes |

## Other

- **Enumeration date:** 01/13/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09900 | BCBS | — |