Provider Demographics
NPI:1679368468
Name:MARY ROSE CORPORATION
Entity type:Organization
Organization Name:MARY ROSE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HYACINTH
Authorized Official - Middle Name:
Authorized Official - Last Name:AKUNNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-973-7764
Mailing Address - Street 1:3879 PACKARD ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-2011
Mailing Address - Country:US
Mailing Address - Phone:734-973-7764
Mailing Address - Fax:734-973-7897
Practice Address - Street 1:22293 SIBLEY RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN
Practice Address - State:MI
Practice Address - Zip Code:48193-8227
Practice Address - Country:US
Practice Address - Phone:734-479-4652
Practice Address - Fax:734-479-6421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home