Organization
ST. JUDE NURSING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY J.M. MALI (OWNER)
(734) 261-4800
Entity
Organization
Contact information
Practice address
34350 ANN ARBOR TRL, LIVONIA, MI 48150-3606
(734) 261-4800
(734) 261-0430
Mailing address
34350 ANN ARBOR TRL, LIVONIA, MI 48150-3606
(734) 261-4800
(734) 261-0430
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
824260
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09568
BCBS OF MI
MI
05
—
4797426
—
MI
05
—
824260
—
MI
Enumeration date
05/02/2006
Last updated
08/06/2012
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