1538219977 NPI number — PROJECT COMPASSION, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538219977 NPI number — PROJECT COMPASSION, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROJECT COMPASSION, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
THE COURTS OF HOLT NURSING AND REHABILITATION
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538219977
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10503 CITATION DR
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
BRIGHTON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48116-6549
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-534-0150
Provider Business Mailing Address Fax Number:
810-534-0208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5091 WILLOUGHBY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48842-1054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
517-694-2144
Provider Business Practice Location Address Fax Number:
517-694-6570
Provider Enumeration Date:
01/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SCHERRER
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
AUTHORIZED AGENT
Authorized Official Telephone Number:
810-534-0150

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  334050 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332BN1400X , with the licence number: 334050 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0C31361 . This is a "BCBS DME P&O" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 09668 . This is a "BCBSM" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 4624335 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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