Canterbury Mi Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CANTERBURY MI OPCO LLC

Practice address

5601 Hatchery Rd
Waterford, MI 48329-3451

Phone

(248) 674-9292

Fax

(248) 674-5344

NPI assigned

Sep 25, 2024

Last updated

Sep 25, 2024By 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

Jacob Taub

Title

Coo

Phone

(718) 838-1500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114744653. Details of each certification follow.

• CCN 235555 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 235555

Legal name

CANTERBURY MI OPCO LLC

Doing business as

THE ORCHARDS AT CANTERBURY ON THE LAKE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Jul 1, 1994

Last certification

Jul 17, 2024

Beds

128

Ownership / control type

Corporation

Multi-facility organization

Wellstone

Organization structure

LLCProprietary

Enrollment address

5601 Hatchery Rd
Waterford, MI 48329-3451

Nursing home name

THE ORCHARDS AT CANTERBURY ON THE LAKE

Affiliated entity

THE ORCHARDS MICHIGAN

Listed as

The Orchards at Canterbury on the LakeCCN 235555 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

1 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jul 1, 1994

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

128107.8 residents per day on average

Chain

The Orchards Michigan15 facilities in the chain

Abuse citation

Cited for abuse (Care Compare abuse icon)

Penalties (3 years)

2Fines totaling $45,461

Processed by Care Compare on Aug 1, 2026.

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.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Emily Kathleen Hurst, D.O.

  • Critical Care Medicine (Internal Medicine) Physician
  • Wyandotte, MI
  • NPI 1215024765

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 5

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

• Big Rapids Mi Opco LLC

  dba The Orchards At Big Rapids

  • Skilled Nursing Facility
  • Big Rapids, MI
  • NPI 1457150609

  White Lake Healthcare LLC

  CMS ownership
• Douglas Cove Mi Opco LLC

  • Skilled Nursing Facility
  • Douglas, MI
  • NPI 1043187578

  White Lake Healthcare LLC

  CMS ownership
• Edgwood Mi Opco LLC

  • Skilled Nursing Facility
  • Three Rivers, MI
  • NPI 1962379404

  White Lake Healthcare LLC

  CMS ownership
• Lapeer Mi Opco LLC

  • Skilled Nursing Facility
  • Lapeer, MI
  • NPI 1922824523

  White Lake Healthcare LLC

  CMS ownership
• Riveridge Mi Opco LLC

  • Skilled Nursing Facility
  • Niles, MI
  • NPI 1023985561

  White Lake Healthcare LLC

  CMS ownership

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)

Affiliated clinicians 2

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

• Yahya F Murad, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • West Bloomfield, MI
  • NPI 1578644712

  Nursing home

  Care Compare affiliation
• Fadi Salloum, MD

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1205874831

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1114744653",
    "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": "248-674-5344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 HATCHERY RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293451",
            "telephone_number": "248-674-9292",
            "fax_number": "248-674-5344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANTERBURY MI OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "TAUB",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "718-838-1500"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• 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 Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.