Provider Demographics
NPI:1841906583
Name:FOX MANOR, INC.
Entity type:Organization
Organization Name:FOX MANOR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ACHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-345-2240
Mailing Address - Street 1:2350 WATKINS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-1468
Mailing Address - Country:US
Mailing Address - Phone:248-886-5840
Mailing Address - Fax:
Practice Address - Street 1:2350 WATKINS LAKE RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-1468
Practice Address - Country:US
Practice Address - Phone:248-886-5840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility