Organization
AUTUMN WOODS RESIDENTIAL HEALTH CARE FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH J WOLF RN (ADMINISTRATOR/VICE PRESIDENT)
(586) 574-3444
Entity
Organization
Contact information
Practice address
29800 HOOVER RD, WARREN, MI 48093-3483
(158) 657-4344
(586) 574-9548
Mailing address
29800 HOOVER RD, WARREN, MI 48093-3483
(158) 657-4344
(586) 574-9548
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
504240
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2155021
—
MI
Enumeration date
07/06/2005
Last updated
09/24/2013
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