Organization
MEDILODGE OF ST. CLAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANA STUEVER (ADMINISTRATOR)
(810) 329-4736
Entity
Organization
Contact information
Practice address
4220 HOSPITAL DR, EAST CHINA, MI 48054-2200
(810) 329-4736
(810) 329-6282
Mailing address
4220 HOSPITAL DR, EAST CHINA, MI 48054-2200
(810) 329-4736
(810) 329-6282
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
744040
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2630271
—
MI
Enumeration date
10/04/2005
Last updated
08/22/2020
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