# WEST BLOOMFIELD SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakes Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679526297
- **Authorized official:** JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
- **Authorized official phone:** (615) 234-5954

## Contact information

- **Practice address:** 2300 HAGGERTY RD, SUITE 1000, WEST BLOOMFIELD, MI 48323-2184
- **Practice address phone:** (248) 896-6300
- **Practice address fax:** (248) 896-6321
- **Mailing address:** 2300 HAGGERTY RD, SUITE 1000, WEST BLOOMFIELD, MI 48323-2184
- **Mailing address phone:** (248) 896-6300
- **Mailing address fax:** (248) 896-6321

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 63-6923 | MI | Yes |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 01/04/2024