Common Ground Santuary

NPI #1972942423 in Pontiac, Michigan

Provider Information

NPI Number: 1972942423
Entity Type: Organization
Organization Name: Common Ground Santuary
Primary Specialty: Nursing Care
Enumeration Date: Jun 18, 2013
Last Updated: Jun 18, 2013

Practice Location

Address: 461 W HURON ST
Address 2: SUITE 100
City: Pontiac
State: Michigan
ZIP Code: 48341-1601
Phone: (248) 456-1991

Authorized Official

Name: MS. BARBARA TANYA-JACKNOW SHREVE, R.N,
Title: STAFF NURSE
Phone: (248) 456-8150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nursing Care	251J00000X	Primary

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