MEDICARE: BERG-LAHSER SNF, LLC

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
1	314000000X	Skilled Nursing Facility

General Provider Information

NPI Number	:	1982235396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BERG-LAHSER SNF, LLC

Provider Business Mailing Address
First Line	:	620 DAVIS ST STE 200
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60201-4419
Country	:	US
Telephone Number	:	773-620-9107
Fax Number	:

Provider Business Practice Location Address
First Line	:	21630 HESSEL AVE # 1230
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48219-1230
Country	:	US
Telephone Number	:	312-590-1055
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	YAIR ZUCKERMAN
Credential	:
Telephone Number	:	312-590-1055

Provider Enumeration Date	:	02/04/2020
Last Update Date	:	02/04/2020

Similar Medicare Providers

1356285282 — MICHIGAN BS OPCO LLC
Practice Location Address:

21630 HESSEL AVE # 1230
DETROIT, MI
48219-1230

Practice Phone: 313-534-8400
Practice Fax:

1720081094 — NORTHWEST PARTNERS, LLC
Practice Location Address:

21630 HESSEL AVE
DETROIT, MI
48219-1230

Practice Phone: 313-534-8400
Practice Fax: 313-534-9839

1326982968 — YOLANDA DANIELLE WELLS
Practice Location Address:

12069 PRAIRIE ST
DETROIT, MI
48204-1230

Practice Phone: 313-729-7340
Practice Fax:

1568806321 — RITA MICHELLE WILLIAMS
Practice Location Address:

1230 N DETROIT AVE
TULSA, OK
74106-4775

Practice Phone: 918-585-8086
Practice Fax:

1992128110 — LOVING HANDS ADULT DAY CARE&THERAPEUTIC CLINIC LLC
Practice Location Address:

1056 S PATRICIA ST
DETROIT, MI
48217-1230

Practice Phone: 313-544-0731
Practice Fax: 313-849-2763

1447807409 — GWENDOLYN MICHELLE SUMMERS
Practice Location Address:

20601 REGENT DR
DETROIT, MI
48205-1230

Practice Phone: 313-468-4440
Practice Fax:

Directions to “BERG-LAHSER SNF, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.