Bortz Greenlake Resthaven, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

634060 Issued in MI

Legal business name

BORTZ GREENLAKE RESTHAVEN, INC

Doing business as

bortz on green lake

Practice address

6470 Alden Dr
Orchard Lake, MI 48324-2006

Phone

(248) 363-4121

Fax

(248) 363-5657

NPI assigned

Nov 1, 2006

Last updated

Aug 22, 2020By 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

Mr. Donald James Bortz

Title

President

Phone

(586) 759-5966

Specialties & licenses 1

Addresses

Other names 1

• bortz on green lake Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487731881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 E 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480893903",
            "telephone_number": "586-759-5966",
            "fax_number": "586-759-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6470 ALDEN DR",
            "city": "ORCHARD LAKE",
            "state": "MI",
            "postal_code": "483242006",
            "telephone_number": "248-363-4121",
            "fax_number": "248-363-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BORTZ GREENLAKE RESTHAVEN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BORTZ",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-759-5966",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "634060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "bortz on green lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elsi Maria Baccari, D.O.
• David Richard Backus, DDS
• Mary Ellen Bardyga, OT
• David Alan Bloom, DDS, MS
• Madeline Boji
• Monisha Manish Chadda, DDS
• David R Backus DDS
• Diamond Transportation Service, LLC
• Diamonds Transportation Services LLC
• Amira Doucette, LPC, LLP

• Skilled Nursing Facility in Orchard Lake, MI
• Providers in Orchard Lake, 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.