Provider Demographics
NPI:1518308576
Name:TURNER SEGUE SKILL BUILDING
Entity Type:Organization
Organization Name:TURNER SEGUE SKILL BUILDING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CACIN
Authorized Official - Middle Name:FREMON
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-574-0795
Mailing Address - Street 1:18701 GRAND RIVER AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-2214
Mailing Address - Country:US
Mailing Address - Phone:313-574-0795
Mailing Address - Fax:313-557-5129
Practice Address - Street 1:18701 GRAND RIVER AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48223-2214
Practice Address - Country:US
Practice Address - Phone:313-574-0795
Practice Address - Fax:313-557-5129
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TURNER SEGUE HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS820291499311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home