Organization
PARKSIDE ESTATES
Active
Other names
Parkside Estates Senior Residence
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY SCOTT RICHARDS (ADMINSTRATOR)
(734) 692-0877
Entity
Organization
Contact information
Practice address
28860 COLEMAN DR, GROSSE ILE, MI 48138-2053
(734) 692-0877
Mailing address
2211 PARKSIDE ST, TRENTON, MI 48183-2512
(734) 692-0877
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
AS820313332
MI
Other
Enumeration date
03/25/2014
Last updated
03/25/2014
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