Organization
PINE CREEK MANOR SKILLED NURSING & REHAB CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAHIM UDDIN (SOLE MEMBER)
(313) 549-7708
Entity
Organization
Contact information
Practice address
34330 VAN BORN RD, WAYNE, MI 48184-2472
(248) 229-1331
(248) 593-9120
Mailing address
30700 TELEGRAPH RD STE 2504, BINGHAM FARMS, MI 48025-4571
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
06/22/2018
Last updated
06/22/2018
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