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Organization
LAUREL HEALTH CARE COMPANY OF PERRINTON
Active
Organization
LAUREL HEALTH CARE COMPANY OF PERRINTON
Active
Other names
THE LAURELS OF FULTON
Organization subpart
No
Provider details
NPI number
Authorized official
ANIS KHAN (CFO)
(248) 386-0300
Entity
Organization
Contact information
Practice address
RFD #1, 4735 RANGER RD, PERRINTON, MI 48871
(989) 236-5433
(989) 236-7672
Mailing address
4000 TOWN CTR STE 2000, SOUTHFIELD, MI 48075-1415
(248) 386-0300
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
294010
MI
314000000X
Skilled Nursing Facility
Primary
294010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09906
BLUE CROSS BLUE SHIELD #
MI
01
—
294010
NURSING HOME LICENSE #
MI
05
—
3202046
—
MI
Enumeration date
05/25/2006
Last updated
09/08/2021
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