Healthcare Provider Details

I. General information

NPI: 1326077009
Provider Name (Legal Business Name): SHERWOOD CARE FACILITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5503 DUFFIELD RD
FLUSHING MI
48433-9766
US

IV. Provider business mailing address

PO BOX 3008
MONTROSE MI
48457-0708
US

V. Phone/Fax

Practice location:
  • Phone: 810-659-5421
  • Fax: 810-659-0807
Mailing address:
  • Phone: 810-659-5421
  • Fax: 810-659-0807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberAM25008267
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberAS2500072548
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateMI

VIII. Authorized Official

Name: SANDRA LEE LAMAY
Title or Position: VICE PRESIDENT
Credential:
Phone: 810-659-5421