Organization
COVENTRY HOMESTEAD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY WAYNE BONEY MECHANICAL ENGINEER (PRESIDENT)
(313) 368-4649
Entity
Organization
Contact information
Practice address
19402 COVENTRY ST, DETROIT, MI 48203-4909
(313) 368-4649
(313) 368-4649
Mailing address
19402 COVENTRY ST, DETROIT, MI 48203-4909
(313) 368-4649
(313) 368-4649
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AS820289860
MI
Other
Enumeration date
07/31/2008
Last updated
07/31/2008
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