Organization
HAGGERTY ROAD OPCO LLC
Active
Other names
Medilodge of Haggerty Road
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE RANEL KIRK (DELEGATED OFFICIAL)
(417) 846-3521
Entity
Organization
Contact information
Practice address
105 N HAGGERTY RD, PLYMOUTH, MI 48170-1801
(734) 455-0510
(734) 455-7359
Mailing address
105 N HAGGERTY RD, PLYMOUTH, MI 48170-1801
(734) 455-0510
(734) 455-7359
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
04/25/2025
Last updated
10/23/2025
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