Provider Demographics
NPI:1932798303
Name:MISSION POINT OF BEVERLY HILLS LLC
Entity Type:Organization
Organization Name:MISSION POINT OF BEVERLY HILLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HARI
Authorized Official - Middle Name:S (ROGER)
Authorized Official - Last Name:MALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-940-5390
Mailing Address - Street 1:30700 TELEGRAPH RD STE 1510
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-5802
Mailing Address - Country:US
Mailing Address - Phone:248-940-5390
Mailing Address - Fax:
Practice Address - Street 1:18200 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:MI
Practice Address - Zip Code:48025-5446
Practice Address - Country:US
Practice Address - Phone:248-647-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility