Organization
FIVE STAR RESIDENTIAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH TANGUAKA RN (STAFF NURSE CARDIAC ICU)
(248) 421-2735
Entity
Organization
Contact information
Practice address
22190 SUSSEX ST, OAK PARK, MI 48237-3509
(248) 421-2735
(248) 677-3082
Mailing address
22190 SUSSEX ST, OAK PARK, MI 48237-3509
(248) 421-2735
(248) 677-3082
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
AS630352375
MI
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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