Samaritas Lutheran Social Services of Michigan

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

10700000219 Issued in MI

Legal business name

SAMARITAS LUTHERAN SOCIAL SERVICES OF MICHIGAN

Practice address

3161 Davenport
Saginaw, MI 48602

Phone

(989) 799-1902

Fax

(989) 799-0805

NPI assigned

Aug 23, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Jenny Cederstrom

Title

Chief Finance Officer

Phone

(586) 506-0325

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Lutheran Social Services of Michigan Former legal business name

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494374400000",
    "number": "1083607238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8131 E. JEFFERSON",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48214",
            "telephone_number": "313-823-7700",
            "fax_number": "313-823-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 DAVENPORT",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "48602",
            "telephone_number": "989-799-1902",
            "fax_number": "989-799-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAS LUTHERAN SOCIAL SERVICES OF MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2017-05-10",
        "status": "A",
        "authorized_official_last_name": "CEDERSTROM",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "CHIEF FINANCE OFFICER",
        "authorized_official_telephone_number": "586-506-0325",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "734110",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "10700000219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09581",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2150787",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lutheran Social Services of Michigan",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Skilled Nursing Facility in Saginaw, MI
• Providers in Saginaw, 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 May 10, 2017; 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.