Provider Demographics
NPI:1720081094
Name:NORTHWEST PARTNERS, LLC
Entity Type:Organization
Organization Name:NORTHWEST PARTNERS, LLC
Other - Org Name:BEACONSHIRE NURSING CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-539-8200
Mailing Address - Street 1:21630 HESSEL AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-1230
Mailing Address - Country:US
Mailing Address - Phone:313-534-8400
Mailing Address - Fax:313-534-9839
Practice Address - Street 1:21630 HESSEL AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-1230
Practice Address - Country:US
Practice Address - Phone:313-534-8400
Practice Address - Fax:313-534-9839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI83-4670314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIS9561OtherBLUE CROSS BLUE SHIELD MI
23-5475Medicare ID - Type UnspecifiedUNITED GOVERNMENT SERVICE