Provider Demographics
NPI:1225035561
Name:ST ANTHONY ACQUISITION COMPANY INC
Entity Type:Organization
Organization Name:ST ANTHONY ACQUISITION COMPANY INC
Other - Org Name:ST ANTHONY HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ASHRAF
Authorized Official - Last Name:QAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-386-0300
Mailing Address - Street 1:31830 RYAN RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-3767
Mailing Address - Country:US
Mailing Address - Phone:586-977-6700
Mailing Address - Fax:586-977-6727
Practice Address - Street 1:31830 RYAN RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-3767
Practice Address - Country:US
Practice Address - Phone:586-977-6700
Practice Address - Fax:586-977-6727
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CIENA HEALTHCARE MANAGEMENT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-01
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4270908Medicaid
MIS9548OtherBCBSM
235408Medicare Oscar/Certification