Organization
MARIAM HOMES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. IMMACULATA OBIOMA NWACHUKWU (DIRECTOR)
(734) 254-0092
Entity
Organization
Contact information
Practice address
42000 KOPPERNICK RD, A-7, CANTON, MI 48187-4282
(734) 254-0092
(734) 254-0180
Mailing address
42000 KOPPERNICK RD, A-7, CANTON, MI 48187-4282
(734) 254-0180
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70738U
REGISTRATION ID NUMBER
MI
Enumeration date
03/19/2010
Last updated
03/19/2010
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