=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962567438
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DURAND SENIOR CARE AND REHAB CENTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/26/2006
-----------------------------------------------------
Last Update Date | 05/05/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8750 MONROE RD
-----------------------------------------------------
City | DURAND
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48429-1000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 989-288-3166
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10503 CITATION DR STE 100
-----------------------------------------------------
City | BRIGHTON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48116-6551
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 810-534-0150
-----------------------------------------------------
Fax | 810-534-0207
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | TODD SANGSTER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 810-534-0150
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BN1400X
-----------------------------------------------------
Taxonomy Name | Nursing Facility Supplies (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 784020
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------