Organization
INKSTER MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CEDRIC JOHNSON (PRESIDENT)
(313) 445-0440
Entity
Organization
Contact information
Practice address
35136 PENNINGTON DR, FARMINGTON HILLS, MI 48335-2044
(313) 445-0440
Mailing address
35136 PENNINGTON DR, FARMINGTON HILLS, MI 48335-2044
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
04/14/2010
Last updated
04/14/2010
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