Provider Demographics
NPI:1205834124
Name:WOODWARD HILLS HEALTH AND REHABILITATION CENTER, LLC
Entity Type:Organization
Organization Name:WOODWARD HILLS HEALTH AND REHABILITATION CENTER, LLC
Other - Org Name:WOODWARD HILLS NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:J
Authorized Official - Last Name:REITERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-220-5560
Mailing Address - Street 1:39312 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-5007
Mailing Address - Country:US
Mailing Address - Phone:248-644-5522
Mailing Address - Fax:248-644-0555
Practice Address - Street 1:39312 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-5007
Practice Address - Country:US
Practice Address - Phone:248-644-5522
Practice Address - Fax:248-644-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI634070314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI235556Medicare Oscar/Certification