Organization
LAUREL HEALTH CARE COMPANY OF PERRINTON
Active
Other names
THE LAURELS OF FULTON
Organization subpart
No
Provider details
NPI number
Authorized official
ANIS KHAN (CFO)
(248) 386-0300
Entity
Organization
Contact information
Practice address
RFD #1, 4735 RANGER RD, PERRINTON, MI 48871
(989) 236-5433
(989) 236-7672
Mailing address
4000 TOWN CTR STE 2000, SOUTHFIELD, MI 48075-1415
(248) 386-0300
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
294010
MI
314000000X
Skilled Nursing Facility
Primary
294010
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09906
BLUE CROSS BLUE SHIELD #
MI
01
—
294010
NURSING HOME LICENSE #
MI
05
—
3202046
—
MI
Enumeration date
05/25/2006
Last updated
09/08/2021
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