Provider Demographics
NPI:1922088780
Name:HENRY FORD CONTINUING CARE CORP
Entity Type:Organization
Organization Name:HENRY FORD CONTINUING CARE CORP
Other - Org Name:HENRY FORD CONTINUING CARE CORPORATION - ROSEVILLE
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-773-6022
Mailing Address - Street 1:19850 HARPER AVENUE
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1804
Mailing Address - Country:US
Mailing Address - Phone:313-640-3375
Mailing Address - Fax:313-822-6789
Practice Address - Street 1:25375 KELLY ROAD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4960
Practice Address - Country:US
Practice Address - Phone:586-773-6022
Practice Address - Fax:586-771-2424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2637693Medicaid
MI2637693Medicaid