1508932419 NPI number — WINDMILL POINTE CARE SOLUTIONS

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 1508932419 NPI number — WINDMILL POINTE CARE SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WINDMILL POINTE CARE SOLUTIONS
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:
Provider Other Organization Name Type Code:
6
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:
1508932419
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/13/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4261
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TROY
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48099-4261
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-633-7929
Provider Business Mailing Address Fax Number:
248-458-0396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2820 W MAPLE RD
Provider Second Line Business Practice Location Address:
SUITE 228
Provider Business Practice Location Address City Name:
TROY
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48084-7011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-633-7929
Provider Business Practice Location Address Fax Number:
248-633-7930
Provider Enumeration Date:
11/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HASSAN
Authorized Official First Name:
MALACHI
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF SUPPORT SERVICES
Authorized Official Telephone Number:
248-633-7929

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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