Healthcare Provider Details

I. General information

NPI: 1861488108
Provider Name (Legal Business Name): LENAWEE MEDICAL CARE FACILITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SAND CREEK HWY
ADRIAN MI
49221-1255
US

IV. Provider business mailing address

200 SAND CREEK HWY
ADRIAN MI
49221-1255
US

V. Phone/Fax

Practice location:
  • Phone: 517-263-6794
  • Fax: 517-263-4275
Mailing address:
  • Phone: 517-263-6794
  • Fax: 517-263-4275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number468510
License Number StateMI

VIII. Authorized Official

Name: MS. ERIN TUCKEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 517-263-6794