Organization
AH WEST BLOOMFIELD SUBTENANT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MALLORY MOCK (EXECUTIVE DIRECTOR)
(248) 538-5283
Entity
Organization
Contact information
Practice address
5859 W MAPLE RD, WEST BLOOMFIELD, MI 48322-2279
(248) 538-5283
(248) 538-5290
Mailing address
5859 W MAPLE RD, WEST BLOOMFIELD, MI 48322-2279
(248) 538-5283
(248) 538-5290
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
07/08/2020
Last updated
07/08/2020
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