# MEADOW BROOK MEDICAL CARE FACILITY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861497398
- **Authorized official:** MRS. JUDY MARTIN RN (ADMINISTRATOR)
- **Authorized official phone:** (231) 533-8661

## Contact information

- **Practice address:** 4543 S M 88 HWY, BELLAIRE, MI 49615-9109
- **Practice address phone:** (231) 533-8661
- **Practice address fax:** (231) 533-4841
- **Mailing address:** 4543 S M 88 HWY, BELLAIRE, MI 49615-9109
- **Mailing address phone:** (231) 533-8661
- **Mailing address fax:** (231) 533-4841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 058510 | MI | Yes |

## Other

- **Enumeration date:** 06/21/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09637 | BLUE CROSS BLUE SHIELD | MI |
| 05 | — | 2085141 | — | MI |