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Organization

REDFORD GERIATRIC VILLAGE, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DONALD JAMES BORTZ (PRESIDENT)
(586) 759-5966
Entity
Organization

Contact information

Practice address
22811 W 7 MILE RD, DETROIT, MI 48219-1739
(313) 543-1440
(313) 534-0643
Mailing address
11700 E 10 MILE RD, WARREN, MI 48089-3903
(586) 759-5966
(586) 759-8006

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
834340
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
602084979
MI
Enumeration date
11/01/2006
Last updated
04/28/2011
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