# THE LAURELS OF CARSON CITY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Laurels of Carson City
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417171844
- **Authorized official:** MR. ANIS KHAN (CFO)
- **Authorized official phone:** (248) 386-0300

## Contact information

- **Practice address:** 620 N. SECOND STREET, CARSON CITY, MI 48811
- **Practice address phone:** (614) 794-8800
- **Practice address fax:** (614) 794-8826
- **Mailing address:** 4000 TOWN CTR, SOUTHFIELD, MI 48075-1410
- **Mailing address phone:** (248) 386-0300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 594041 | MI | Yes |

## Other

- **Enumeration date:** 04/13/2007
- **Last updated:** 09/10/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5256082 | — | MI |