Organization
WOODHAVEN OF LIVONIA
Active
Organization
WOODHAVEN OF LIVONIA
Active
Other names
Woodhaven Retirement Community
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL W. GASSER (EXECUTIVE DIRECTOR)
(734) 261-9000
Entity
Organization
Contact information
Practice address
29667 WENTWORTH ST, LIVONIA, MI 48154-6231
(734) 261-9000
(734) 261-9003
Mailing address
29667 WENTWORTH ST, LIVONIA, MI 48154-6231
(734) 261-9000
(734) 261-9003
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
314000000X
Skilled Nursing Facility
824514
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4625216
—
MI
Enumeration date
05/08/2006
Last updated
06/23/2023
Update your record
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