Healthcare Provider Details

I. General information

NPI: 1649225335
Provider Name (Legal Business Name): LAUREL HEALTH CARE COMPANY OF MT PLEASANT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S CRAPO ST
MT PLEASANT MI
48858-2944
US

IV. Provider business mailing address

4000 TOWN CTR STE 2000
SOUTHFIELD MI
48075-1415
US

V. Phone/Fax

Practice location:
  • Phone: 989-773-5918
  • Fax: 989-772-3656
Mailing address:
  • Phone: 248-386-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number374010
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number374010
License Number StateMI

VIII. Authorized Official

Name: ANIS KHAN
Title or Position: CFO
Credential:
Phone: 248-386-0300