Provider Demographics
NPI:1700883030
Name:ARISTA MANAGEMENT, INC.
Entity Type:Organization
Organization Name:ARISTA MANAGEMENT, INC.
Other - Org Name:QUALICARE NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:ASHRAF
Authorized Official - Last Name:QAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-386-0300
Mailing Address - Street 1:695 E GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-2525
Mailing Address - Country:US
Mailing Address - Phone:313-925-6655
Mailing Address - Fax:313-925-1355
Practice Address - Street 1:695 E GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-2525
Practice Address - Country:US
Practice Address - Phone:313-925-6655
Practice Address - Fax:313-925-1355
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CIENA HEALTHCARE MANAGEMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-01
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3179921Medicaid
S9601OtherBCBSM
MI3179921Medicaid