Boulevard Manor L.l.c.

NPI #1063712586 in Detroit, Michigan

Provider Information

NPI Number
1063712586
Entity Type
Organization
Organization Name
Boulevard Manor L.l.c.
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Nov 1, 2010
Last Updated
Apr 20, 2011

Practice Location

Address
464 E GRAND BLVD
ZIP Code
48207-3637
Phone
(313) 579-2255

Authorized Official

Name
FAHIM UDDIN
Title
AUTHORIZED MEMBER
Phone
(313) 579-2255

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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