Provider Demographics
NPI:1881225621
Name:MISSION POINT OF FOREST HILLS, LLC
Entity Type:Organization
Organization Name:MISSION POINT OF FOREST HILLS, LLC
Other - Org Name:MISSION POINT NURSING & PHYSICAL REHABILITATION CENTER OF FOREST HILLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HARI
Authorized Official - Middle Name:S (ROGER)
Authorized Official - Last Name:MALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-577-2632
Mailing Address - Street 1:721 ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-2867
Mailing Address - Country:US
Mailing Address - Phone:248-577-2632
Mailing Address - Fax:
Practice Address - Street 1:1095 MEDICAL PARK DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-3685
Practice Address - Country:US
Practice Address - Phone:616-949-7220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility