Organization
REGENCY ON THE LAKE-FORT GRATIOT, LLC
Active
Parent organization
CIENA HEALTHCARE MANAGEMENT, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CIENA HEALTHCARE MANAGEMENT, INC
Authorized official
MR. MOHAMMAD ASHRAF QAZI (CEO)
(248) 386-0300
Entity
Organization
Contact information
Practice address
5669 LAKESHORE RD, FORT GRATIOT, MI 48059-2817
(810) 385-7260
Mailing address
5669 LAKESHORE RD, FORT GRATIOT, MI 48059-2817
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09594
BCBSM PROVIDER CODE
MI
05
—
4988052
—
MI
Enumeration date
01/11/2007
Last updated
03/30/2010
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