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Organization
CANTERBURY HEALTH CARE, INC
Active
Organization
CANTERBURY HEALTH CARE, INC
Active
Other names
Canterbury On-the-Lake
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A DRUTCHAS (CHAIRMAN)
(248) 674-9292
Entity
Organization
Contact information
Practice address
5601 HATCHERY RD, WATERFORD, MI 48329
(248) 674-9292
(248) 674-5393
Mailing address
5601 HATCHERY RD, WATERFORD, MI 48329-3451
(248) 674-9292
(248) 674-5393
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1070000051
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09755
BLUE CROSS/ BLUE SHIELD M
—
05
—
60 2083058
—
MI
01
—
F0000008663
BLUE CARE NETWORK
—
Enumeration date
09/15/2006
Last updated
08/28/2019
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