Organization
SOUTH LYON SENIOR CARE AND REHAB CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD SANGSTER (CFO)
(810) 534-0150
Entity
Organization
Contact information
Practice address
700 REYNOLD SWEET PKWY, SOUTH LYON, MI 48178-1816
(248) 437-2048
(248) 437-0837
Mailing address
10503 CITATION DR STE 100, BRIGHTON, MI 48116-6551
(810) 534-0150
(810) 534-0208
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
634270
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5505974
—
MI
01
—
S9637
BCBSM
MI
Enumeration date
10/31/2008
Last updated
05/05/2022
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