# LAKESHORE SENIOR CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LAKESHORE LEGACY GROUP FAMILY LIMITED PARTNERSHIP
- **Other names:** Lakeshore Senior Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1568804169
- **Legal business name:** LAKESHORE LEGACY GROUP FAMILY LIMITED PARTNERSHIP
- **Authorized official:** MR. SCOTT JAMES BOLTHOUSE (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (616) 994-9900

## Contact information

- **Practice address:** 320 N 120TH AVE, STE 230, HOLLAND, MI 49424-2696
- **Practice address phone:** (616) 994-9900
- **Mailing address:** 320 N 120TH AVE, STE 230, HOLLAND, MI 49424-2696
- **Mailing address phone:** (616) 994-9900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/24/2013
- **Last updated:** 07/24/2013