Rhema Southgate Operating LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

824290 Issued in MI

Legal business name

RHEMA SOUTHGATE OPERATING LLC

Doing business as

Manor of Southgate Skilled Nursing and Rehabilitation

Practice address

15400 Trenton Rd
Southgate, MI 48195

Phone

(734) 284-4620

Fax

(734) 284-0851

NPI assigned

May 5, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shannon M Hack

Title

Cfo

Phone

(248) 569-8400

Specialties & licenses 1

Addresses

Other names 1

• Manor of Southgate Skilled Nursing and Rehabilitation Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487602959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17515 W NINE MILE RD",
            "address_2": "SUITE 925",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48075",
            "telephone_number": "248-569-8400",
            "fax_number": "248-569-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 TRENTON RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "48195",
            "telephone_number": "734-284-4620",
            "fax_number": "734-284-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RHEMA SOUTHGATE OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HACK",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "248-569-8400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "824290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manor of Southgate Skilled Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maria-Celia Florence Revita
• Kiana Reyes
• Victor Reyes
• Alma Reygaert
• Mandy Reynolds
• Eric Rice
• Erica Rice
• Sherry Rice
• Elizabeth Richards
• Melanie Jane Richards

• Skilled Nursing Facility in Southgate, MI
• Providers in Southgate, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.