Provider Demographics
NPI:1467617209
Name:TRUE LIGHT TRANSITIONAL HOME
Entity Type:Organization
Organization Name:TRUE LIGHT TRANSITIONAL HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HURT
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:248-796-2454
Mailing Address - Street 1:PO BOX 20703
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-0703
Mailing Address - Country:US
Mailing Address - Phone:248-796-2454
Mailing Address - Fax:
Practice Address - Street 1:10150 BURTON AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-1799
Practice Address - Country:US
Practice Address - Phone:248-796-2454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care