NPIMap

Organization Active NPI

Laurel Health Care Company of Wayland

Doing business as The Laurels of Sandy Creek

  • Skilled Nursing Facility
  • Wayland, MI
National Provider Identifier
1114972817
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
034030 Issued in MI
Legal business name
LAUREL HEALTH CARE COMPANY OF WAYLAND
Doing business as
The Laurels of Sandy Creek
Practice address
425 E Elm St
Wayland, MI 49348-1109
Phone
(616) 792-2249
Fax
(616) 792-6121
NPI assigned
May 23, 2006
Last updated
Sep 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Authorized official

Name
Anis Khan
Title
Cfo
Phone
(248) 386-0300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 034030 MI
Skilled Nursing Facility 314000000X 034030 MI Primary

Addresses

Primary practice location

425 E Elm St
Wayland, MI 49348-1109

Mailing address

4000 Town Ctr Ste 2000
Southfield, MI 48075-1415
Phone (248) 386-0300

Other identifiers 3

IdentifierTypeStateIssuer
09945OtherMIBLUE CROSS BLUE SHIELD #
3202091MedicaidMI
034030OtherMINURSING HOME LICENSE #

Other names 1

  • THE LAURELS OF SANDY CREEK Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101216000081 MI Part A Provider - Skilled Nursing Facility 3870781990 Practice locations: Wayland, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1114972817. Details of each certification follow.

Skilled nursing facility certification: CCN 235313

Legal name
LAUREL HEALTH CARE COMPANY OF WAYLAND
Doing business as
THE LAURELS OF SANDY CREEK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Oct 1, 1976
Last certification
May 21, 2025
Beds
99
Ownership / control type
Individual
Multi-facility organization
Ciena Healthcare
Organization structure
CorporationProprietary
Incorporated
Jun 16, 1995 in MI
Enrollment address
425 E Elm St
Wayland, MI 49348-1109
Nursing home name
THE LAURELS OF SANDY CREEK
Affiliated entity
CIENA HEALTHCARE/LAUREL HEALTH CARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Laurels of Sandy CreekCCN 235313 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Oct 1, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9970.0 residents per day on average
Chain
Ciena Healthcare/Laurel Health Care81 facilities in the chain
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
1Fines totaling $14,020

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Laurel Health Care Company of Wayland2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

425 E Elm St
Wayland, MI 49348
Phone (269) 792-2249

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Ciena Healthcare Management Inc Organization, Southfield, MI Corporation Operational/Managerial Control Jan 1, 2021 100%
David Stobb Individual Corporate OfficerSecretary & General Counsel Feb 1, 2016
Susan Barnosky Individual Contracted Managing EmployeeAdministrator Jun 30, 2022
Anis Khan Individual Corporate OfficerTreasurer & Cfo Feb 1, 2016
Mohammad a. Qazi Individual 5% Or Greater Indirect Ownership InterestPresident & Ceo Feb 1, 2016 100%
Corporate Officer Feb 1, 2016
Corporate Director Feb 1, 2016
Laurel Health Care Holdings, Inc. Organization, Westerville, OH For-profit 5% Or Greater Direct Ownership Interest Jan 6, 2006 100%
Operational/Managerial Control Jan 6, 2006

Facilities with the same owner 76

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

View all 76

Practitioners & affiliated clinicians

Practitioners 4

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 2

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": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1114972817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 TOWN CTR STE 2000",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480751415",
            "telephone_number": "248-386-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E ELM ST",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481109",
            "telephone_number": "616-792-2249",
            "fax_number": "616-792-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL HEALTH CARE COMPANY OF WAYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ANIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "248-386-0300"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MI",
            "license": "034030",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "034030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "09945",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3202091",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING HOME LICENSE #",
            "identifier": "034030",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE LAURELS OF SANDY CREEK",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THE LAURELS OF SANDY CREEK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wayland, MI

Sources for this page

Verify at the official NPI Registry.