Organization
SOUTHFIELD OPCO LLC
Active
Other names
MEDILODGE OF SOUTHFIELD
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STACEY PAUL ROGERS (CHIEF FINANCIAL OFFICER)
(502) 429-8062
Entity
Organization
Contact information
Practice address
26715 GREENFIELD RD, SOUTHFIELD, MI 48076-4717
(248) 557-0050
(248) 557-6434
Mailing address
7400 NEW LA GRANGE RD, SUITE 100, LOUISVILLE, KY 40222-4870
(502) 429-8062
(502) 429-0650
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
07/15/2013
Last updated
12/30/2014
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