# REGENCY AT INDEPENDENCE TOWNSHIP, LLC

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

## Provider details

- **NPI number:** 1912496324
- **Authorized official:** MOHAMMAD QAZI (MANAGER/OWNER)
- **Authorized official phone:** (248) 262-2357

## Contact information

- **Practice address:** 6211 STONEWOOD DRIVE, CLARKSTON, MI 48346
- **Practice address phone:** (248) 262-2357
- **Mailing address:** 4000 TOWN CTR STE 700, SOUTHFIELD, MI 48075-1424
- **Mailing address phone:** (248) 262-2357

## Taxonomy

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

## Other

- **Enumeration date:** 05/02/2018
- **Last updated:** 05/02/2018