Canterbury Health Care, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1070000051 Issued in MI

Legal business name

CANTERBURY HEALTH CARE, INC

Doing business as

Canterbury On-the-Lake

Practice address

5601 Hatchery Rd
Waterford, MI 48329

Phone

(248) 674-9292

Fax

(248) 674-5393

NPI assigned

Sep 15, 2006

Last updated

Aug 28, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cheryl A Drutchas

Title

Chairman

Phone

(248) 674-9292

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Canterbury On-the-Lake Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fadi Salloum, MD

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1205874831
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566950400000",
    "number": "1013013275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 HATCHERY RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293451",
            "telephone_number": "248-674-9292",
            "fax_number": "248-674-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 HATCHERY RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "48329",
            "telephone_number": "248-674-9292",
            "fax_number": "248-674-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTERBURY HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2019-08-28",
        "status": "A",
        "authorized_official_last_name": "DRUTCHAS",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "248-674-9292"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "1070000051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD M",
            "identifier": "09755",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60 2083058",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "F0000008663",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canterbury On-the-Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Canterbury On-the-Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steffany Lynn Butler
• Jaleesa Buyck
• Jazmira Cabil
• Kate Caddy, PSY.D.
• Meghan Callahan, LLMSW
• Canterbury Health Care, Inc (Canterbury On-the-Lake)
• Canterbury Mi Opco LLC
• Canterbury Village Mi Opco LLC
• Jessica Lynn Cantrell, MA
• Hannah Rose Cardinale, RN

• Skilled Nursing Facility in Waterford, MI
• Providers in Waterford, MI by specialty
• Skilled Nursing Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.