Organization
AH LAKESIDE II LDHA LLC
Active
Other names
Baldwin House Lakeside II
Organization subpart
No
Provider details
NPI number
Authorized official
AUBREY BROHL (EXECUTIVE DIRECTOR)
(586) 263-0081
Entity
Organization
Contact information
Practice address
15821 19 MILE RD, CLINTON TOWNSHIP, MI 48038-6320
(586) 263-0081
(586) 412-1672
Mailing address
15821 19 MILE RD, CLINTON TOWNSHIP, MI 48038-6320
(586) 263-0081
(586) 412-1672
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
05/14/2020
Last updated
07/15/2021
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