MEDILODGE OF SOUTHFIELD, INC. (NPI# 1457311052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457311052 |
| Entity Type | Organization |
| Organization Name | MEDILODGE OF SOUTHFIELD, INC. |
| Practice Address |
26715 Greenfield Rd Southfield MI 48076-4717 |
| Mailing Address |
64500 Van Dyke Rd Washington MI 48095-2583 |
| Practice Telephone | 2485570050 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2008-07-29 |
| Authorized Official Name | KATHLEEN DENEAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5867525008 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 634480 | MI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE CROSS OF MICHIGAN | 09707 | 01 |
| MI | 3076568 | 05 |
| Street Address |
26715 GREENFIELD RD |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48076-4717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770109746 | Diana Marciniak | Speech-Language Pathologist | 26715 Greenfield Rd, Southfield, MI 48076-4717 | 2020-06-24 |
| 1114489143 | Jalen Weaver | Physical Therapist | 26715 Greenfield Rd, Southfield, MI 48076-4717 | 2019-03-31 |
| 1366924284 | Germelina Aguirre Fowler | Occupational Therapist | 26715 Greenfield Rd, Southfield, MI 48076-4717 | 2018-09-06 |
| 1760823074 | Southfield Opco LLC | Skilled Nursing Facility | 26715 Greenfield Rd, Southfield, MI 48076-4717 | 2013-07-15 |
| 1659515872 | Machlah B Lopian | Physician Assistant | 26715 Greenfield Rd, Southfield, MI 48076-4717 | 2009-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942813753 | Elaine Sarah Kahn | Social Worker | 15999 West Twelve Mile Rd, Southfield, MI 48076 | 2020-08-31 |
| 1295353829 | Marian Hannah Ibrahim | Dentist | 19189 W 12 Mile Rd, Lathrup Village, MI 48076 | 2020-07-09 |
| 1699317669 | Meadow Lane Rehabilitative Therapies LLC | Social Worker | 29895 Greenfield Rd., Suite 104b, Southfield, MI 48076 | 2019-10-11 |
| 1760035752 | Taliah Laneice Williams-hunter | Counselor | 30119 Sparkleberry Dr., Southfield, MI 48076 | 2019-07-19 |
| 1386114742 | Mavis Gail Pookrum | Technician | 21732 Colony Park Circle #105, Southfield, MI 48076 | 2018-11-28 |
| 1861962417 | Millennial Infusion Centers Inc | Clinic/Center | 26250 Northwestern Hwy Ste 201, Southfield, MI 48076 | 2018-11-27 |
| 1215429212 | Debra Deanes | Counselor | 30233 Southfiels Rd, 203, Southfield, MI 48076 | 2018-06-05 |
| 1437675758 | Kenneth Gerard Giles | Counselor | 29532 Southfield Rd. Suite 208, Southfield, MI 48076 | 2017-08-17 |
| 1902346836 | Linsk Psychiatry Services P C | Clinic/Center | 21751 W 12 Mile Rd, Suite 205, Southfield, MI 48076 | 2017-02-25 |
| 1023552361 | Massage Serenity | Community/Behavioral Health | 20245 W. 12 Mile Rd, Suite 113, Southfield, MI 48076 | 2016-12-06 |
| Find all providers in zip 48076 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902067580 | Reliability Home Health Services,p.c. | Skilled Nursing Facility | 19111 W 10 Mile Rd Ste 112, Southfield, MI 48075-2449 | 2008-06-17 |
| 1003812181 | Evergreen Health and Rehabilitation Center, LLC | Skilled Nursing Facility | 19933 W 13 Mile Rd, Southfield, MI 48076-1024 | 2005-06-23 |
| 1760823074 | Southfield Opco LLC | Skilled Nursing Facility | 26715 Greenfield Rd, Southfield, MI 48076-4717 | 2013-07-15 |
| 1538253687 | Lakeland Neuro Care Center Ptr | Skilled Nursing Facility | 26900 Franklin Rd, Southfield, MI 48033-5312 | 2006-10-03 |
| 1386625143 | Southfield Rehabilitation Company | Skilled Nursing Facility | 22401 Foster Winter Drive, Southfield, MI 48075-3724 | 2005-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538798731 | Windemere Park of Troy Operations LLC | Skilled Nursing Facility | 5990 N Adams Rd, Troy, MI 48098-2377 | 2020-04-08 |
| 1982235396 | Berg-lahser Snf, LLC | Skilled Nursing Facility | 21630 Hessel Ave # 1230, Detroit, MI 48219-1230 | 2020-02-04 |
| 1508497918 | Harmony Village Snf, LLC | Skilled Nursing Facility | 16588 Schaefer Hwy # 4249, Detroit, MI 48235-4249 | 2020-02-04 |
| 1336795244 | Ishpeming Nursing & Rehab Center, LLC | Skilled Nursing Facility | 435 Rd Pl, Ishpeming, MI 49849 | 2019-08-15 |
| 1669965299 | Wellbridge of Clarkston, LLC | Skilled Nursing Facility | 5655 Clarkston Road, Independence Township, MI 48348 | 2018-06-08 |
| 1104318112 | Wellbridge At Genesys Health Park, LLC | Skilled Nursing Facility | 3139 East Baldwin Road, Grand Blanc, MI 48439 | 2018-06-05 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1912496324 | Regency At Independence Township, LLC | Skilled Nursing Facility | 6211 Stonewood Drive, Clarkston, MI 48346 | 2018-05-02 |
| 1972092344 | Regency At Grand Haven, LLC | Skilled Nursing Facility | 17049 Comstock St, Grand Haven, MI 49417-7903 | 2018-05-01 |
| 1093214173 | Sana Nasir Inc. | Skilled Nursing Facility | 13840 King Rd, Riverview, MI 48193 | 2018-02-05 |
| Find all providers with the same taxonomy | ||||
| City | SOUTHFIELD |
| Zip Code | 48076 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.