Medilodge Of Royal Oak
Skilled Nursing Facility in Royal Oak, MI. Organization (NPI-2).
NPI number1396705992
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1396705992
- Entity type
- Organization (NPI-2)
- Legal business name
- Medilodge Of Royal Oak
- Organization subpart
- No
- Enumeration date
- Mar 27, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 634360 | MI | Yes |
Practice location
3030 Greenfield RdRoyal Oak, MI 48073-6528
Phone 248-288-6610
Mailing address
64500 Van Dyke RdWashington, MI 48095-2583
Authorized official
Jan Kueppers
Chief Financial Officer
5867525008
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