Provider Demographics
NPI:1225351349
Name:EXTENDED STAY HOTELS
Entity Type:Organization
Organization Name:EXTENDED STAY HOTELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AREA OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-767-0124
Mailing Address - Street 1:1501 BRIARWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1662
Mailing Address - Country:US
Mailing Address - Phone:248-767-0124
Mailing Address - Fax:
Practice Address - Street 1:1501 BRIARWOOD CIR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1662
Practice Address - Country:US
Practice Address - Phone:248-767-0124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service