Organization
LAUREL HEALTH CARE COMPANY OF GALESBURG
Active
Other names
THE LAURELS OF GALESBURG
Organization subpart
No
Provider details
NPI number
Authorized official
ANIS KHAN (CFO)
(248) 386-0300
Entity
Organization
Contact information
Practice address
1080 N 35TH ST, GALESBURG, MI 49053-9727
(616) 665-7043
(616) 665-4080
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
394150
MI
314000000X
Skilled Nursing Facility
Primary
394150
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09796
BLUE CROSS BLUE SHIELD #
MI
05
—
3319728
—
MI
01
—
394150
NURSING HOME LICENSE #
MI
Enumeration date
05/23/2006
Last updated
09/13/2021
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