Bolton Brook Manor

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

BOLTON BROOK MANOR

Doing business as

Caremore of Metamora

Practice address

4554 Thomas Rd
Metamora, MI 48455-9220

Phone

(810) 678-2087

Fax

(810) 678-2766

NPI assigned

Jul 27, 2020

Last updated

Jul 27, 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. Sunil R Bhattad

Title

Administrator

Phone

(248) 797-8519

Specialties & licenses 2

Addresses

Other names 1

• Caremore of Metamora Doing business as

Locations

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1497364442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4554 THOMAS RD",
            "city": "METAMORA",
            "state": "MI",
            "postal_code": "484559220",
            "telephone_number": "810-678-2087",
            "fax_number": "810-678-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4554 THOMAS RD",
            "city": "METAMORA",
            "state": "MI",
            "postal_code": "484559220",
            "telephone_number": "810-678-2087",
            "fax_number": "810-678-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOLTON BROOK MANOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "BHATTAD",
        "authorized_official_first_name": "SUNIL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-797-8519",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caremore of Metamora",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roy Mumin Alisoglu, CRNA
• Paige Elizabeth Bailey
• Ashley Baker
• Kelly Bayley
• Michael John Boyd
• Jordan V Buscemi, PHARMACY STUDENT
• Andria Leigh Connor, COTA/L
• Eric E Craig, LLP
• Jeannie Craig, TLLP, LLPC

• Assisted Living Facility (Mental Illness) in Metamora, MI
• Providers in Metamora, MI by specialty
• Assisted Living Facility (Mental Illness) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.