# NEW LIGHT BAPTIST CHURCH NURSING HOME, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** New Light Nursing Home, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720071707
- **Authorized official:** MR. GEORGE B. TALLEY (ADMINISTRATOR)
- **Authorized official phone:** (313) 491-7920

## Contact information

- **Practice address:** 9500 GRAND RIVER AVE, DETROIT, MI 48204-2132
- **Practice address phone:** (313) 491-7920
- **Practice address fax:** (313) 491-0510
- **Mailing address:** 9500 GRAND RIVER AVE, DETROIT, MI 48204-2132
- **Mailing address phone:** (313) 491-7920
- **Mailing address fax:** (313) 491-0510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 2152057 | MI | Yes |

## Other

- **Enumeration date:** 08/25/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2152057 | — | MI |