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
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