- Enrollment id
- O20040318001173
- Enrollment state
- MI
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1265439590
- Multiple npi flag
- Y
- Ccn
- 235500
- Associate id
- 6709776115
- Organization name
- G & K MANAGEMENT SERVICES INC
- Doing business as name
- OMNI CONTINUING CARE
- Incorporation date
- 1982-12-29
- Incorporation state
- MI
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- OMNI CONTINUING CARE
- Affiliation entity name
- CIENA HEALTHCARE/LAUREL HEALTH CARE
- Affiliation entity id
- 144
- Address line 1
- 5201 CONNER ST
- City
- DETROIT
- State
- MI
- Zip code
- 482133405