Provider Demographics
NPI:1902814163
Name:BALMORAL, INC.
Entity Type:Organization
Organization Name:BALMORAL, INC.
Other - Org Name:OAKWOOD SKILLED NURSING, TRENTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:WELDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-253-6017
Mailing Address - Street 1:5500 FORT ST
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-4602
Mailing Address - Country:US
Mailing Address - Phone:734-671-3500
Mailing Address - Fax:734-671-3769
Practice Address - Street 1:5500 FORT ST
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-4602
Practice Address - Country:US
Practice Address - Phone:734-671-3500
Practice Address - Fax:734-671-3769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI824022314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI235052OtherHAP
MI2708543Medicaid
MI5172122OtherAETNA
MI9963411OtherCIGNA
MI000000005083OtherCAPE HEALTH
MI009916OtherMIDWEST HEALTH
MI127859OtherGREAT LAKES HEALTH
MI09551OtherBLUE CROSS
MI09551OtherBLUE CARE NETWORK
MISN820008OtherM-CARE
MI137997OtherCARE CHOICES
MI235052OtherHAP