Provider Demographics
NPI:1336939214
Name:PRENTIS LOFT LLC
Entity type:Organization
Organization Name:PRENTIS LOFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:MCNEARY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:313-333-5192
Mailing Address - Street 1:2147 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-3126
Mailing Address - Country:US
Mailing Address - Phone:313-333-5192
Mailing Address - Fax:
Practice Address - Street 1:2143 HARDING ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3126
Practice Address - Country:US
Practice Address - Phone:313-332-0143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility