Organization
LAUREL HEALTH CARE COMPANY OF HUDSONVILLE
Active
Other names
THE LAURELS OF HUDSONVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
ANIS KHAN (CFO)
(248) 386-0300
Entity
Organization
Contact information
Practice address
3650 VAN BUREN ST, HUDSONVILLE, MI 49426-1036
(616) 669-1520
(616) 669-4640
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
704050
MI
314000000X
Skilled Nursing Facility
Primary
704050
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09882
BLUE CROSS BLUE SHIELD #
MI
05
—
3478134
—
MI
01
—
704050
NURSING HOME LICENSE #
MI
Enumeration date
05/23/2006
Last updated
09/10/2021
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