BEECHWOOD MANOR INC NPI 1962603753

NPI Information

  • NPI: 1962603753
  • Provider Name: BEECHWOOD MANOR INC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • CLIA Number: 23D2216440
  • Address: 24600 GREATER MACK AVE
    ST CLAIR SHORES, MI
    ZIP 48080
  • Phone: (586) 773-5950

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NPI Details

BEECHWOOD MANOR INC is an assisted living facility in St Clair Shores, MI. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. BEECHWOOD MANOR INC NPI is 1962603753. The provider is registered as an organization entity type.

The provider's business location address is:

24600 GREATER MACK AVE
ST CLAIR SHORES, MI
ZIP 48080
Phone: (586) 773-5950
Fax: (586) 773-0783

The provider's authorized official is Nouhad Srour .
The authorized official title is Administrator and has the following contact phone number (586) 773-5950.

The CLIA number assigned to this NPI record is 23D2216440 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/30/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityMICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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