Organization
NORTHWEST MI OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROB KORN (MANAGER)
(718) 838-1501
Entity
Organization
Contact information
Practice address
16181 HUBBELL ST, DETROIT, MI 48235-4026
(718) 838-1501
Mailing address
362 E KENNEDY BLVD, LAKEWOOD, NJ 08701-1434
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/01/2021
Last updated
10/05/2021
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