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Organization
AH LAKESIDE II LDHA LLC
Active
Organization
AH LAKESIDE II LDHA LLC
Active
Other names
Baldwin House Lakeside II
Organization subpart
No
Provider details
NPI number
Authorized official
AUBREY BROHL (EXECUTIVE DIRECTOR)
(586) 263-0081
Entity
Organization
Contact information
Practice address
15821 19 MILE RD, CLINTON TOWNSHIP, MI 48038-6320
(586) 263-0081
(586) 412-1672
Mailing address
15821 19 MILE RD, CLINTON TOWNSHIP, MI 48038-6320
(586) 263-0081
(586) 412-1672
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
—
NULL
376J00000X
Homemaker
—
NULL
376J00000X
Homemaker
—
—
Other
Enumeration date
05/14/2020
Last updated
07/15/2021
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