Organization
HAMPTON MANOR OF SHELBY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS EDWARD JR. (EXECUTIVE DIRECTOR)
(248) 930-7875
Entity
Organization
Contact information
Practice address
51831 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-4454
(586) 333-4940
Mailing address
51831 VAN DYKE AVE, SHELBY TOWNSHIP, MI 48316-4454
(586) 333-4940
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AH500387033
STATE OF MICHIGAN HFA LICENSE
MI
Enumeration date
12/03/2019
Last updated
12/03/2019
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