NPIMap

Organization Active NPI

South Lyon Senior Care and Rehab Center, LLC

  • Skilled Nursing Facility
  • South Lyon, MI
National Provider Identifier
1053564252
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
634270 Issued in MI
Legal business name
SOUTH LYON SENIOR CARE AND REHAB CENTER, LLC
Practice address
700 Reynold Sweet Pkwy
South Lyon, MI 48178-1816
Phone
(248) 437-2048
Fax
(248) 437-0837
NPI assigned
Oct 31, 2008
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Todd Sangster
Title
Cfo
Phone
(810) 534-0150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 634270 MI Primary

Addresses

Primary practice location

700 Reynold Sweet Pkwy
South Lyon, MI 48178-1816

Mailing address

10503 Citation Dr Ste 100
Brighton, MI 48116-6551
Phone (810) 534-0150

Other identifiers 2

IdentifierTypeStateIssuer
5505974MedicaidMI
S9637OtherMIBCBSM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081218000607 MI Part A Provider - Skilled Nursing Facility 3476615881 Practice locations: South Lyon, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053564252. Details of each certification follow.

Skilled nursing facility certification: CCN 235065

Legal name
SOUTH LYON SENIOR CARE AND REHAB CENTER, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Feb 20, 2025
Beds
74
Ownership / control type
Corporation
Multi-facility organization
Nexcare Wellbridge
Organization structure
LLCProprietary
Incorporated
Apr 2, 2008 in MI
Enrollment address
700 Reynold Sweet Parkway
South Lyon, MI 48178-1816
Nursing home name
SOUTH LYON SENIOR CARE AND REHAB CENTER
Affiliated entity
NEXCARE HEALTH SYSTEMS

Care Compare: Nursing home

Medicare Care Compare
Listed as
South Lyon Senior Care and Rehab CenterCCN 235065 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7468.5 residents per day on average
Chain
Nexcare Health Systems20 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0670003South Lyon Senior Care and Rehab Center LLC700 Reynold Sweet Parkway, South Lyon, MI 48178Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James Branscum Individual 5% Or Greater Indirect Ownership Interest Dec 1, 2013 31%
Nexcare Health Systems, LLC Organization, Brighton, MI LLC Operational/Managerial Control Jan 1, 2005
Michael D Perry Individual Operational/Managerial Control Aug 1, 2015
Kevin Beardsley Individual W-2 Managing EmployeeExecutive Director Dec 3, 2015
Todd M Sangster Individual Corporate Officer Nov 4, 2013
Robin Eisenberg 2014 Family Trust Organization, Farmington Hills, MI 5% Or Greater Indirect Ownership Interest Apr 1, 2014 31%
Nexcare Holdings, LLC Organization, Brighton, MI LLC 5% Or Greater Direct Ownership Interest Oct 31, 2013 100%
Leo Eisenberg Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2014 31%
Frank M Wronski Individual 5% Or Greater Indirect Ownership Interest Apr 1, 2014 31%

Facilities with the same owner 27

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 27

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1053564252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10503 CITATION DR STE 100",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481166551",
            "telephone_number": "810-534-0150",
            "fax_number": "810-534-0208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 REYNOLD SWEET PKWY",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481781816",
            "telephone_number": "248-437-2048",
            "fax_number": "248-437-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LYON SENIOR CARE AND REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-31",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "SANGSTER",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "810-534-0150"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "634270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5505974",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "S9637",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

Verify at the official NPI Registry.