# MEDILODGE OF MILFORD, LLC

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

## Provider details

- **NPI number:** 1720248644
- **Authorized official:** KATHLEEN DENEAN (CHIEF EXECUTIVE OFFICIER)
- **Authorized official phone:** (586) 752-5008

## Contact information

- **Practice address:** 555 HIGHLAND AVE, MILFORD, MI 48381-1517
- **Practice address phone:** (248) 685-1460
- **Practice address fax:** (248) 684-1564
- **Mailing address:** 555 HIGHLAND AVE, MILFORD, MI 48381-1517
- **Mailing address phone:** (586) 752-5008
- **Mailing address fax:** (586) 752-7609

## Taxonomy

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

## Other

- **Enumeration date:** 06/13/2008
- **Last updated:** 09/04/2013