Provider Demographics
NPI:1225271471
Name:CONTINUUM GERIATRIC SERVICES OF MI
Entity Type:Organization
Organization Name:CONTINUUM GERIATRIC SERVICES OF MI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DEWITTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-930-9743
Mailing Address - Street 1:23550 HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2614
Mailing Address - Country:US
Mailing Address - Phone:248-930-9743
Mailing Address - Fax:866-394-8956
Practice Address - Street 1:23550 HAGGERTY RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2614
Practice Address - Country:US
Practice Address - Phone:248-930-9743
Practice Address - Fax:866-394-8956
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTINUUM GERIATRIC SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty