Provider Demographics
NPI:1720236920
Name:HEARTLAND OF WEST BLOOMFIELD MI LLC
Entity Type:Organization
Organization Name:HEARTLAND OF WEST BLOOMFIELD MI LLC
Other - Org Name:THE COURTS AT WEST BLOOMFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT-REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-252-5518
Mailing Address - Street 1:333 N SUMMIT ST
Mailing Address - Street 2:ATTN BARRY A LAZARUS
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1531
Mailing Address - Country:US
Mailing Address - Phone:419-252-5541
Mailing Address - Fax:419-254-5494
Practice Address - Street 1:6950 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-3220
Practice Address - Country:US
Practice Address - Phone:248-661-1700
Practice Address - Fax:248-661-7834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility