Provider Demographics
NPI:1912549486
Name:SZR NORTHVILLE ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:SZR NORTHVILLE ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MAZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PILUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-420-4000
Mailing Address - Street 1:16100 N HAGGERTY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4857
Mailing Address - Country:US
Mailing Address - Phone:734-420-4000
Mailing Address - Fax:734-420-4688
Practice Address - Street 1:16100 N HAGGERTY RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4857
Practice Address - Country:US
Practice Address - Phone:734-420-4000
Practice Address - Fax:734-420-4688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility