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NPI Code Detail

MEDICARE: LAKE ORION NURSING CENTER CORPORATION

MEDICARE: LAKE ORION NURSING CENTER CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility634024MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134125131
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE ORION NURSING CENTER CORPORATION
Provider Business Mailing Address
First Line : 585 E FLINT ST
Second Line :
City : LAKE ORION
State : MI
Zip : 48362-3209
Country : US
Telephone Number : 248-693-0505
Fax Number : 248-693-6071
Provider Business Practice Location Address
First Line : 585 E FLINT ST
Second Line :
City : LAKE ORION
State : MI
Zip : 48362-3209
Country : US
Telephone Number : 248-693-0505
Fax Number : 248-693-6071
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MR. MATT LEGAULT
Credential :
Telephone Number : 248-338-5691
Provider Enumeration Date : 06/23/2005
Last Update Date : 05/23/2016

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Directions to “LAKE ORION NURSING CENTER CORPORATION ” Practice Location

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