Provider Demographics
NPI:1770291809
Name:VAB SENIOR LIMITED DIVIDEND HOUSING ASSOCIATION LLC
Entity type:Organization
Organization Name:VAB SENIOR LIMITED DIVIDEND HOUSING ASSOCIATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-392-5521
Mailing Address - Street 1:1957 S. TELEGRAPH RD.
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341
Mailing Address - Country:US
Mailing Address - Phone:248-213-8403
Mailing Address - Fax:989-885-5906
Practice Address - Street 1:1957 S. TELEGRAPH RD.
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:248-213-8403
Practice Address - Fax:989-885-5906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3867OtherINDEPENDENT LIVING FACILITY