Laurel Health Care Company of Perrinton
Organization Active NPI Skilled Nursing Facility · Perrinton, MI
NPI 1104872977 · NPPES record last updated Sep 8, 2021
Key facts
- NPI
- 1104872977
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 294010 (MI)
- Legal business name
- LAUREL HEALTH CARE COMPANY OF PERRINTON
- Practice address
- RFD #1
4735 Ranger Rd
Perrinton, MI 48871 - Phone
- (989) 236-5433
- Fax
- (989) 236-7672
- NPI assigned
- May 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Anis Khan
- Title
- Cfo
- Phone
- (248) 386-0300
Owners & managing parties with NPI records 1
Corporate family (same tax ID) 1
Facilities with the same owner 80
Practitioners 3
-
Muhammad Asad Arshad, M.B.B.S, MD
-
Garrett Howard Smith, M.D.
Affiliated clinicians 2
-
Muhammad Asad Arshad, M.B.B.S, MD
Medicare Care Compare: Nursing home
- Listed as
- The Laurels of Fulton
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★★★★★ 5 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Dec 26, 1991
- Medicare certification status
- Active
- Certified beds
- 50 · 40.6 residents per day on average
- Chain
- Ciena Healthcare/Laurel Health Care
- Penalties (3 years)
- 2 · fines totaling $58,635
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Skilled nursing facility certification: CCN 235513
- Legal name
- LAUREL HEALTH CARE COMPANY OF PERRINTON
- Doing business as
- THE LAURELS OF FULTON
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 26, 1991
- Last certification
- Nov 21, 2024
- Beds
- 50
- Ownership / control type
- Corporation
- Multi-facility organization
- Ciena
- Organization structure
- Corporation · Proprietary
- Incorporated
- Oct 1, 1995 in MI
- Enrollment address
- RFD #1 4735 W Ranger Road
Perrinton, MI 48871-9775 - Nursing home name
- THE LAURELS OF FULTON
- Affiliated entity
- CIENA HEALTHCARE/LAUREL HEALTH CARE
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Fulton Senior Leasing, LLC |
Adp of the SNF | Jan 1, 2021 | |
| Ciena Healthcare Management Inc |
Operational/Managerial Control | Jan 1, 2021 | 100% |
| Adp of the SNF | Mar 28, 2025 | ||
| Adam Patrick |
Operational/Managerial Control | Oct 7, 2024 | |
| Adp of the SNF | Oct 7, 2024 | ||
| David Stobb |
Corporate Officer |
Feb 1, 2016 | 100% |
| Adp of the SNF | Jan 1, 2021 | ||
| |
Adp of the SNF | Mar 28, 2025 | |
| Anis Khan |
Corporate Officer |
Feb 1, 2016 | |
| Operational/Managerial Control | Feb 1, 2016 | ||
| Adp of the SNF | Feb 1, 2016 | ||
| Laurel Acquisition Holding Corporation |
5% Or Greater Indirect Ownership Interest | Feb 1, 2016 | 100% |
| |
Adp of the SNF | Mar 28, 2025 | |
| Mohammad a. Qazi |
5% Or Greater Indirect Ownership Interest |
Feb 1, 2016 | 100% |
| Corporate Officer |
Feb 1, 2016 | 100% | |
| Corporate Director |
Feb 1, 2016 | 100% | |
| Operational/Managerial Control | Jan 1, 2021 | ||
| Adp of the SNF | Jan 1, 2021 | ||
| Mohammad a Qazi Living Trust Dated 09/26/97 |
5% Or Greater Indirect Ownership Interest | Feb 1, 2016 | 100% |
| Adp of the SNF | Feb 1, 2016 | ||
| Justin P Di Rezze |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Laurel Health Care Holdings, Inc. |
5% Or Greater Direct Ownership Interest | Feb 1, 2016 | 100% |
| Direct Ownership Interest | Feb 1, 2016 | 100% | |
| |
Adp of the SNF | Jan 17, 2022 | |
| |
Adp of the SNF | Dec 1, 2024 | |
| |
Adp of the SNF | Mar 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111110000786 | MI | Part a Provider - Skilled Nursing Facility | 0941474886 | Practice locations: Perrinton, MI |
National Provider Directory
- Tax ID family
- Laurel Health Care Company of Perrinton
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | 294010 | MI | |
| Skilled Nursing Facility | 314000000X | 294010 | MI | Yes |
Addresses
Primary practice location
RFD #1
4735 Ranger Rd
Perrinton, MI 48871
Mailing address
4000 Town Ctr Ste 2000
Southfield, MI 48075-1415
Phone (248) 386-0300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 294010 | Other | MI | NURSING HOME LICENSE # |
| 3202046 | Medicaid | MI | |
| 09906 | Other | MI | BLUE CROSS BLUE SHIELD # |
Other names
- THE LAURELS OF FULTON
Other providers in Perrinton, MI
- Theresa May Copeland
- Sarah Jane Dempsey
- Lou Anne Dick
- Ralph L. Kendall Jr.
- Laurel Health Care Company of Perrinton
- Alicia Smolinski
- Marissa Struble
- Natalie Elizabeth Wempa
All providers in Perrinton, MI · Skilled Nursing Facility in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.