Organization
ST JOHN SENIOR COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOMASINE F MARX (VICE PRESIDENT FINANCE)
(586) 753-0310
Entity
Organization
Contact information
Practice address
18300 E WARREN, DETROIT, MI 48224
(313) 343-8000
(313) 343-8959
Mailing address
28000 DEQUINDRE, WARREN, MI 48092
(586) 753-0310
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
BHS834032
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09900
BCBS
—
Enumeration date
01/13/2006
Last updated
08/22/2020
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