Provider Demographics
NPI:1497342653
Name:STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Entity Type:Organization
Organization Name:STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF BUSINESS SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-275-1183
Mailing Address - Street 1:47901 SUGARBUSH RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:47901 SUGARBUSH RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047
Practice Address - Country:US
Practice Address - Phone:586-719-6791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-22
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MINAMedicaid