# CANTERBURY HEALTH CARE, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Canterbury On-the-Lake
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013013275
- **Authorized official:** CHERYL A DRUTCHAS (CHAIRMAN)
- **Authorized official phone:** (248) 674-9292

## Contact information

- **Practice address:** 5601 HATCHERY RD, WATERFORD, MI 48329
- **Practice address phone:** (248) 674-9292
- **Practice address fax:** (248) 674-5393
- **Mailing address:** 5601 HATCHERY RD, WATERFORD, MI 48329-3451
- **Mailing address phone:** (248) 674-9292
- **Mailing address fax:** (248) 674-5393

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1070000051 | MI | Yes |

## Other

- **Enumeration date:** 09/15/2006
- **Last updated:** 08/28/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09755 | BLUE CROSS/ BLUE SHIELD M | — |
| 05 | — | 60 2083058 | — | MI |
| 01 | — | F0000008663 | BLUE CARE NETWORK | — |