Provider Demographics
NPI:1366066201
Name:PRESBYTERIAN VILLAGE WESTLAND
Entity type:Organization
Organization Name:PRESBYTERIAN VILLAGE WESTLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-762-8885
Mailing Address - Street 1:32001 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-7902
Mailing Address - Country:US
Mailing Address - Phone:734-762-8885
Mailing Address - Fax:
Practice Address - Street 1:32001 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-7902
Practice Address - Country:US
Practice Address - Phone:734-762-8885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESBYTERIAN VILLAGES OF MICHIGAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-06
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Multi-Specialty
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities