Provider Demographics
NPI:1528476249
Name:WELLBRIDGE OF NOVI LLC
Entity type:Organization
Organization Name:WELLBRIDGE OF NOVI LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:SANGSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-534-0150
Mailing Address - Street 1:48300 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374
Mailing Address - Country:US
Mailing Address - Phone:248-662-2300
Mailing Address - Fax:248-662-2304
Practice Address - Street 1:48300 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1718
Practice Address - Country:US
Practice Address - Phone:248-662-2300
Practice Address - Fax:248-662-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2022-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility